Professional Documents
Culture Documents
Children in
an Urban World
THE STATE OF THE
WORLD’S CHILDREN
2012
© United Nations Children’s Fund (UNICEF) Photographs
February 2012
Cover
Permission is required to reproduce any part of this Children dance in an informal settlement on
publication. Permission will be freely granted to a hillside in Caracas, Bolivarian Republic
educational or non-profit organizations. Others will of Venezuela (2007).
be requested to pay a small fee. Please contact: © Jonas Bendiksen/Magnum Photos
Division of Communication, UNICEF
3 United Nations Plaza, New York, NY 10017, USA Chapter 1, page x
Tel: +1 (212) 326-7434 Children play in Tarlabasi, a neighbourhood that
Email: nyhqdoc.permit@unicef.org is home to many migrants in Istanbul, Turkey.
© UNICEF/NYHQ2005-1185/Roger LeMoyne
This report and additional online content are available
at <www.unicef.org/sowc2012>. Perspective and Focus Chapter 2, page 12
On essays represent the personal views of the authors Queuing for water at Camp Luka, a slum on the
and do not necessarily reflect the position of the United outskirts of Kinshasa, Democratic Republic of
Nations Children’s Fund. the Congo.
© UNICEF/NYHQ2008-1027/Christine Nesbitt
For corrigenda subsequent to printing,
please see <www.unicef.org/sowc2012>. Chapter 3, page 34
A girl in Kirkuk, Iraq, drags scrap metal that her
For latest data, please visit <www.childinfo.org>. family will use to reinforce their home – a small
space with curtains for walls on the top floor of
ISBN: 978-92-806-4597-2 a former football stadium.
eISBN: 978-92-806-4603-0 © UNICEF/NYHQ2007-2316/Michael Kamber
United Nations publication sales no.: E.12.XX.1
Chapter 4, page 48
Boys play football in the courtyard of the Centre
Sauvetage BICE, which offers residential and
family services for vulnerable children in Abidjan,
Côte d’Ivoire.
© UNICEF/NYHQ2011-0549/Olivier Asselin
Chapter 5, page 66
Girls and boys work on a group project in a primary
school in Tarawa, Kiribati.
© UNICEF/NYHQ2006-2457/Giacomo Pirozzi
Acknowledgements
This report is the fruit of collaboration among many individuals and institutions. The editorial and research team thanks all
who gave so generously of their expertise and energy, in particular:
Sheridan Bartlett (City University of New York); Jean Christophe Fotso (APHRC); Nancy Guerra (University of California);
Eva Jesperson (UNDP); Jacob Kumaresan (WHO Urban HEART); Gora Mboup (UN-Habitat); Sheela Patel (SDI);
Mary Racelis (Ateneo de Manila University); Eliana Riggio; David Satterthwaite (IIED); Ita Sheehy (UNHCR);
Nicola Shepherd (UNDESA); Mats Utas (Swedish Academy of Letters); and Malak Zaalouk (American University of Cairo),
for serving on the External Advisory Board.
Sheridan Bartlett; Roger Hart and Pamela Wridt (City University of New York); Carolyn Stephens (London School of
Hygiene and Tropical Medicine and National University of Tucuman, Argentina); and Laura Tedesco (Universidad Autonoma
de Madrid), for authoring background papers.
Fred Arnold (ICF Macro); Ricky Burdett (London School of Economics and Political Science); Elise Caves and Cristina Diez
(ATD Fourth World Movement); Michael Cohen (New School); Malgorzata Danilczuk-Danilewicz; Celine d’Cruz (SDI);
Robert Downs (Columbia University); Sara Elder (ILO); Kimberly Gamble-Payne; Patrick Gerland (UNDESA); Friedrich
Huebler (UNESCO); Richard Kollodge (UNFPA); Maristela Monteiro (PAHO); Anushay Said (World Bank Institute);
Helen Shaw (South East Public Health Observatory); Mark Sommers (Tufts University); Tim Stonor (Space Syntax Ltd.);
Emi Suzuki (World Bank); Laura Turquet (UN-Women); Henrik Urdal (Harvard Kennedy School); and Hania Zlotnik
(UNDESA), for providing information and advice.
Special thanks to Sheridan Bartlett, Gora Mboup and Amit Prasad (WHO) for their generosity of intellect and spirit.
UNICEF country and regional offices and headquarters divisions contributed to this report by submitting findings and
photographs, taking part in formal reviews or commenting on drafts. Many field offices and UNICEF national committees
arranged to translate or adapt the report for local use.
Programme, policy, communication and research advice and support were provided by Geeta Rao Gupta, Deputy Executive
Director; Rima Salah, Deputy Executive Director; Gordon Alexander, Director, Office of Research; Nicholas Alipui,
Director, Programme Division; Louis-Georges Arsenault, Director, Office of Emergency Programmes; Colin Kirk, Director,
Evaluation Office; Khaled Mansour, Director, Division of Communication; Richard Morgan, Director, Division of Policy
and Practice; Lisa Adelson-Bhalla; Christine De Agostini; Stephen Antonelli; Maritza Ascencios; Lakshmi Narasimhan Balaji;
Gerrit Beger; Wivina Belmonte; Rosangela Berman-Bieler; Aparna Bhasin; Nancy Binkin; Susan Bissell; Clarissa Brocklehurst;
Marissa Buckanoff; Sally Burnheim; Jingqing Chai; Kerry Constabile; Howard Dale; Tobias Dierks; Kathryn Donovan;
Paul Edwards; Solrun Engilbertsdottir; Rina Gill; Bjorn Gillsater; Dora Giusti; Judy Grayson; Attila Hancioglu;
Peter Harvey; Saad Houry; Priscillia Kounkou Hoveyda; Robert Jenkins; Malene Jensen; Theresa Kilbane; Jimmy Kolker;
June Kunugi; Boris De Luca; Susanne Mikhail Eldhagen; Sam Mort; Isabel Ortiz; Shannon O’Shea; Kent Page;
Nicholas Rees; Maria Rubi; Rhea Saab; Urmila Sarkar; Teghvir Singh Sethi; Fran Silverberg; Peter Smerdon; Antony Spalton;
Manuela Stanculescu; David Stewart; Jordan Tamagni; Susu Thatun; Renee Van de Weerdt; and Natalia Elena Winder-Rossi.
Special thanks to Catherine Langevin-Falcon, Chief, Publications Section, who oversaw the editing and production of the
statistical tables and provided essential expertise, guidance and continuity amid changes in personnel.
Finally, a particular debt of gratitude is owed to David Anthony, Chief, Policy Advocacy, and editor of this report for the past
seven editions, for his vision, support and encouragement.
Report team
EDITORIAL AND RESEARCH STATISTICAL TABLES
Abid Aslam, Julia Szczuka, Editors Tessa Wardlaw, Associate Director, Statistics and
Nikola Balvin, Sue Le-Ba, Meedan Mekonnen, Monitoring Section, Division of Policy and Practice;
Research officers Priscilla Akwara; David Brown; Danielle Burke;
Chris Brazier, Writer Xiaodong Cai; Claudia Cappa; Liliana Carvajal; Archana
Marc Chalamet, French editor Dwivedi; Anne Genereux; Elizabeth Horn-Phatanothai;
Carlos Perellon, Spanish editor Claes Johansson; Rouslan Karimov; Mengjia Liang;
Hirut Gebre-Egziabher, Lead, Yasmine Hage, Lisa Kenney, Rolf Luyendijk; Nyein Nyein Lwin; Colleen Murray;
Anne Ytreland, Jin Zhang, Research assistants Holly Newby; Khin Wityee Oo; Nicole Petrowski;
Charlotte Maitre, Lead, Anna Grojec, Chiho Suzuki; Danzhen You
Carol Holmes, Copy editors
Celine Little, Dean Malabanan, Anne Santiago, ONLINE PRODUCTION AND IMAGES
Judith Yemane, Editorial and administrative support Stephen Cassidy, Chief, Internet, Broadcast and
Image Section; Matthew Cortellesi; Susan Markisz;
PRODUCTION AND DISTRIBUTION Keith Musselman; Ellen Tolmie; Tanya Turkovich
Jaclyn Tierney, Chief, Print and Translation Section;
Germain Ake; Fanuel Endalew; Jorge Peralta-Rodriguez; Design by Green Communication Design inc.
Elias Salem; Nogel S. Viyar; Edward Ying Jr. Printed by Brodock Press, Inc.
Acknowledgements iii
ACTION
The experience of childhood is increasingly urban. Over half the world’s people – including more than a
billion children – now live in cities and towns. Many children enjoy the advantages of urban life, including
access to educational, medical and recreational facilities. Too many, however, are denied such essentials as
electricity, clean water and health care – even though they may live close to these services. Too many are
forced into dangerous and exploitative work instead of being able to attend school. And too many face a
constant threat of eviction, even though they live under the most challenging conditions – in ramshackle
dwellings and overcrowded settlements that are acutely vulnerable to disease and disaster.
The hardships endured by children in poor communities are often concealed – and thus perpetuated – by the
statistical averages on which decisions about resource allocation are based. Because averages lump every-
one together, the poverty of some is obscured by the wealth of others. One consequence of this is that
children already deprived remain excluded from essential services.
Increasing numbers of children are growing up in urban areas. They must be afforded the amenities and
opportunities they need to realize their rights and potential. Urgent action must be taken to:
• Better understand the scale and nature of poverty and exclusion affecting children in urban areas.
• Ensure that urban planning, infrastructure development, service delivery and broader efforts to
reduce poverty and inequality meet the particular needs and priorities of children.
• Promote partnership between all levels of government and the urban poor – especially children
and young people.
• Pool the resources and energies of international, national, municipal and community actors in
support of efforts to ensure that marginalized and impoverished children enjoy their full rights.
These actions are not goals but means to an end: fairer, more nurturing cities and societies for all people –
starting with children.
When many of us think of the world’s poorest children, the image that comes readily to mind is that of a
child going hungry in a remote rural community in sub-Saharan Africa – as so many are today.
But as The State of the World’s Children 2012 shows with clarity and urgency, millions of children in cities
and towns all over the world are also at risk of being left behind.
In fact, hundreds of millions of children today live in urban slums, many without access to basic services.
They are vulnerable to dangers ranging from violence and exploitation to the injuries, illnesses and death
that result from living in crowded settlements atop hazardous rubbish dumps or alongside railroad tracks.
And their situations – and needs – are often represented by aggregate figures that show urban children to be
better off than their rural counterparts, obscuring the disparities that exist among the children of the cities.
This report adds to the growing body of evidence and analysis, from UNICEF and our partners, that scar-
city and dispossession afflict the poorest and most marginalized children and families disproportionately.
It shows that this is so in urban centres just as in the remote rural places we commonly associate with
deprivation and vulnerability.
The data are startling. By 2050, 70 per cent of all people will live in urban areas. Already, 1 in 3 urban
dwellers lives in slum conditions; in Africa, the proportion is a staggering 6 in 10. The impact on children
living in such conditions is significant. From Ghana and Kenya to Bangladesh and India, children living
in slums are among the least likely to attend school. And disparities in nutrition separating rich and poor
children within the cities and towns of sub-Saharan Africa are often greater than those between urban and
rural children.
Every disadvantaged child bears witness to a moral offense: the failure to secure her or his rights to survive,
thrive and participate in society. And every excluded child represents a missed opportunity – because when soci-
ety fails to extend to urban children the services and protection that would enable them to develop as productive
and creative individuals, it loses the social, cultural and economic contributions they could have made.
We must do more to reach all children in need, wherever they live, wherever they are excluded and left
behind. Some might ask whether we can afford to do this, especially at a time of austerity in national
budgets and reduced aid allocations. But if we overcome the barriers that have kept these children from
the services that they need and that are theirs by right, then millions more will grow up healthy, attend
school and live more productive lives.
Anthony Lake
Executive Director, UNICEF
Foreword v
An urban world
This graphic depicts countries and territories with urban
populations exceeding 100,000. Circles are scaled in
proportion to urban population size. Where space allows,
numbers within circles show urban population (in millions)
and urban percentage of the country’s population.
Sweden Finland
Norway 7.9
Estonia
Denmark Latvia
Iceland
Lithuania
Netherlands
13.8 Belarus
Ireland
United 83% Germany Poland
7.2
Canada Kingdom 23.3
27.4 49.4 Belgium 60.8 61%
10.4 Ukraine
81% 80% 97% 74% Czech 31.3
Republic
7.7
Slovakia 69%
Luxembourg
France Austria Hungary Romania Republic of
United States
Switzerland 12.3 Moldova
53.5 Slovenia
57%
Serbia
of America
Croatia
85% Bulgaria
Bosnia and
Italy Herzegovina The former
Turkey
255.4 Spain 41.4
Yugoslav
Montenegro Republic of
Macedonia
Albania 50.7
Georgia
Azerbaijan
35.7 68%
82% 77%
Greece
70% Armenia
Malta
Cyprus Syrian Arab Iraq
Portugal Republic
Lebanon
11.4
21.0
Tunisia Occupied
Palestinian Territory 56% 66%
Morocco Algeria 7.1
Mexico 18.6 23.6 Israel Jordan
Bahamas 58% 66% Libya Egypt Kuwait
88.3
Niger
35.2 Bahrain
78% Cuba Mauritania
Chad 43% Saudi Arabia
Qatar
8.5 United Arab
22.5
Mali Emirates
Guatemala Belize Senegal 82%
Haiti Dominican Cape Verde
7.1 Republic
Honduras
Burkina Sudan Yemen Oman
Gambia
El Salvador
Jamaica
Faso Nigeria 17.5 Eritrea 7.6
Nicaragua Guinea-Bissau Guinea 40% Djibouti
Barbados
Ghana
78.9 Ethiopia
Venezuela Trinidad and Tobago Sierra Leone Somalia
Costa Rica 12.6 13.8
Panama
(Bolivarian
Republic of)
Côte
Liberia d’Ivoire
51%
50% Central 17%
Guyana African
27.1 Suriname 10.0
Republic
Colombia 93% 51%
Togo Benin Cameroon
Uganda
Kenya
34.8 11.4
Rwanda
9.0
58%
75% Burundi
Equatorial Guinea
Sao Tome and Principe Gabon United Republic
Ecuador
9.7
Brazil Congo
Democratic
Republic
of Tanzania
11.8
26%
168.7
of the Congo
23.2
Peru Malawi Comoros
35%
22.4
77%
Bolivia
87% Angola
11.2 Mozambique Mauritius
Zambia
(Plurinational 59% 9.0 Madagascar
State of)
Botswana Zimbabwe
Paraguay Namibia Swaziland
South Lesotho
Africa
Chile
15.2 30.9
Uruguay
89% 62%
Argentina
37.3
92%
Source: United Nations, Department of Economic and Social Affairs (UNDESA), Population Division special updated estimates of urban population as of October 2011, consistent with
World Population Prospects: The 2010 revision and World Urbanization Prospects: The 2009 revision. Graphic presentation of data based on The Guardian, 27 July 2007.
This map is stylized and based on an approximate scale. It does not reflect a position by UNICEF on the legal status of any country or territory or the delimitation of any frontiers.
China
Kazakhstan
9.4 629.8 Democratic People’s
Urban population in millions Republic of Korea
Kyrgyzstan 14.7
Uzbekistan
47%
60%
10.0
36% Tajikistan
Republic
Turkmenistan
Afghanistan Percentage urban of Korea Japan
7.1
40.0 84.6
Iran Pakistan 83% Canton
(Islamic 14.567%
Republic of) 62.3
52.3 36%
71%
Bhutan
Nepal
Bangladesh
41.7
India 28%
Myanmar
Lao People’s
Democratic
Republic Viet Nam
26.7
367.5
16.1
34% 30%
Thailand
Philippines
23.5 45.6
30% 34%
Cambodia 49%
Malaysia
20.5
Brunei Darussalam
72%
Singapore
Sri Lanka
Maldives
Timor-Leste
Indonesia
106.2 Papua New Guinea
Fiji
Australia
19.8
89%
New Zealand
Notes: Because of the cession in July 2011 of the Republic of South Sudan by the Republic of the Sudan, and its subsequent admission to the United Nations on 14 July 2011,
data for the Sudan and South Sudan as separate States are not yet available. Data presented are for the Sudan pre-cession.
Data for China do not include Hong Kong and Macao, Special Administrative Regions of China. Hong Kong became a Special Administrative Region (SAR) of China as of 1 July 1997;
Macao became a SAR of China as of 20 December 1999.
Data for France do not include French Guiana, Guadeloupe, Martinique, Mayotte and Reunion.
Data for the Netherlands do not include the Netherlands Antilles.
Data for the United States of America do not include Puerto Rico and United States Virgin Islands.
Panels
Chapter 3 Social determinants of urban health. . . . . . . . . . . . . . . . . . . . 4
Urban challenges. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 35
Slums: The five deprivations. . . . . . . . . . . . . . . . . . . . . . . . . . . 5
Migrant children . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 35
Definitions . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 10
Economic shocks. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 40
The Convention on the Rights of the Child. . . . . . . . . . . . . . 16
Violence and crime . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 42
The Millennium Development Goals. . . . . . . . . . . . . . . . . . . 33
Disaster risk. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 45
Agents, not victims. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 38
Armed conflict and children in urban areas . . . . . . . . . . . . . 42
Contents ix
CHAPTER
© UNICEF/NYHQ2005-1185/Roger LeMoyne
Children in
an increasingly
urban world
The day is coming when the majority of the world’s been uneven, and millions of children in marginalized
children will grow up in cities and towns. Already, half urban settings confront daily challenges and depriva-
of all people live in urban areas. By mid-century, over tions of their rights.
two thirds of the global population will call these places
home. This report focuses on the children – more than Traditionally, when children’s well-being is assessed, a
one billion and counting – who live in urban settings comparison is drawn between the indicators for chil-
around the world. dren in rural areas and those in urban settings. As
expected, urban results tend to be better, whether in
Urban areas offer great potential to secure children’s terms of the proportion of children reaching their first
rights and accelerate progress towards the Millennium or fifth birthday, going to school or gaining access to
Development Goals (MDGs). Cities attract and gener- improved sanitation. But these comparisons rest on
ate wealth, jobs and investment, and are therefore aggregate figures in which the hardships endured by
associated with economic development. The more poorer urban children are obscured by the wealth of
urban a country, the more likely it is to have higher communities elsewhere in the city.
incomes and stronger institutions.1 Children in urban
areas are often better off than their rural counter- Where detailed urban data are available, they reveal
parts thanks to higher standards of health, protection, wide disparities in children’s rates of survival, nutritional
education and sanitation. But urban advances have status and education resulting from unequal access to
services. Such disaggregated information is hard to find, that children confront. These instances show that it is
however, and for the most part development is pursued, possible to fulfil commitments to children – but only
and resources allocated, on the basis of statistical aver- if all children receive due attention and investment
ages. One consequence of this is that children living and if the privilege of some is not allowed to obscure
in informal settlements and impoverished neighbour- the disadvantages of others. Accordingly, the final
hoods are excluded from essential services and social chapter of this report identifies broad policy actions that
protection to which they have a right. This is happen- should be included in any strategy to reach excluded chil-
ing as population growth puts existing infrastructure dren and foster equity in urban settings riven by disparity.
and services under strain and urbanization becomes
nearly synonymous with slum formation. According
to the United Nations Human Settlements Programme An urban future
(UN-Habitat), one city dweller in three lives in slum By 2050, 7 in 10 people will live in urban areas. Every
conditions, lacking security of tenure in overcrowded, year, the world’s urban population increases by approx-
unhygienic places characterized by unemployment, imately 60 million people. Most of this growth is
pollution, traffic, crime, a high cost of living, poor taking place in low- and middle-income countries. Asia
service coverage and competition over resources. is home to half of the world’s urban population and
66 out of the 100 fastest-growing urban areas, 33 of
This report focuses mainly on those children in urban which are in China alone. Cities such as Shenzhen, with a
settings all over the world who face a particularly 10 per cent rate of annual increase in 2008, are doubling
complex set of challenges to their development and the in population every seven years.2 Despite a low overall
fulfilment of their rights. Following an overview of the rate of urbanization, Africa has a larger urban population
world’s urban landscape, Chapter 2 looks at the status than North America or Western Europe, and more than
of children in urban settings through the lens of inter- 6 in 10 Africans who live in urban areas reside in slums.
national human rights instruments and development
goals. Chapter 3 examines some of the phenomena New urban forms are evolving as cities expand and
shaping the lives of children in urban areas, from their merge. Nearly 10 per cent of the urban population is
reasons for coming to the city and their experience of found in megacities – each with more than 10 million
migration to the challenges posed by economic shocks, people – which have multiplied across the globe.
violence and acute disaster risk. New York and Tokyo, on the list since 1950, have
been joined by a further 19, all but 3 of them in Asia,
Clearly, urban life can be harsh. It need not be. Many Latin America and Africa. Yet most urban growth is
cities have been able to contain or banish diseases that taking place not in megacities but in smaller cities and
were widespread only a generation ago. Chapter 4 pre- towns, home to the majority of urban children and
sents examples of efforts to improve the urban realities young people.3
In contrast to rapid urban growth in the developing suggests that children born into existing urban popula-
world, more than half of Europe’s cities are expected tions account for around 60 per cent of urban growth.6
to shrink over the next two decades.4 The size of the
urban population in high-income countries is projected
to remain largely unchanged through 2025, however, Poverty and exclusion
with international migrants making up the balance.5 For billions of people, the urban experience is one
of poverty and exclusion. Yet standard data collec-
Migration from the countryside has long driven urban tion and analysis fail to capture the full extent of both
growth and remains a major factor in some regions. problems. Often, studies overlook those residents of a
But the last comprehensive estimate, made in 1998, city whose homes and work are unofficial or unreg-
istered – precisely those most likely to be poor or
suffer discrimination. Moreover, official definitions of
Figure 1.2. Urban population growth is greater in poverty seldom take sufficient account of the cost of
less developed regions non-food needs. In consequence, poverty thresholds
World urban population (0–19 years old)
applied to urban populations make inadequate allow-
Millions ance for the costs of transport, rent, water, sanitation,
1,200
schooling and health services.7
1,000
Difficult urban living conditions reflect and are exac-
erbated by factors such as illegality, limited voice in
800 decision-making and lack of secure tenure, assets
and legal protection. Exclusion is often reinforced by
600 discrimination on the grounds of gender, ethnicity, race
or disability. In addition, cities often expand beyond
400 the capacity of the authorities to provide the infrastruc-
ture and services needed to ensure people’s health and
200 well-being. A significant proportion of urban popula-
tion growth is occurring in the most unplanned and
0
deprived areas. These factors combine to push essen-
1950 1955 1960 1965 1970 1975 1980 1985 1990 1995 2000 2005 tial services beyond the reach of children and families
Less developed regions living in poor urban neighbourhoods.
Least developed countries (a subset of less developed regions)
More developed regions Physical proximity to a service does not guarantee
Source: UNDESA, Population Division. access. Indeed, many urban inhabitants live close to
Stark disparities in health between rich and poor have social policy prioritizing adequate housing; water and
drawn attention to the social determinants of health, or sanitation; food security; efficient waste management
the ways in which people’s health is affected not only systems; and safer places to live, work and play can
by the medical care and support systems available to effectively reduce health risk factors. Good governance
prevent and manage illness, but also by the economic, that enables families from all urban strata to access
social and political circumstances in which they are born high-quality services – education, health, public trans-
and live. portation and childcare, for example – can play a major
part in safeguarding the health of children in urban
The urban environment is in itself a social determinant environments.
of health. Urbanization drove the emergence of public
health as a discipline because the concentration of Growing awareness of the potential of societal
people in towns and cities made it easier for communicable circumstances to help or harm individuals’ health has
diseases to spread – mainly from poorer quarters to wealth- led to such initiatives as the World Health Organization’s
ier ones. An increasingly urban world is also contributing to Commission on Social Determinants of Health. Its recom-
the rising incidence of non-communicable diseases, obesity, mendations emphasize that effectively addressing the
alcohol and substance abuse, mental illness and injuries. causes of poor health in urban areas requires a range
of solutions, from improving living conditions, through
Many poor and marginalized groups live in slums and investment in health systems and progressive taxation, to
informal settlements, where they are subjected to a improved governance, planning and accountability at the
multitude of health threats. Children from these commu- local, national and international levels. The challenges
nities are particularly vulnerable because of the stresses are greatest in low- and middle-income countries, where
of their living conditions. As the prevalence of physical rapid urban population growth is seldom accompanied by
and social settings of extreme deprivation increases, so adequate investment in infrastructure and services. The
does the risk of reversing the overall success of disease Commission has also highlighted the need to address the
prevention and control efforts. inequalities that deny power and resources to margin-
alized populations, including women, indigenous people
The urban environment need not harm people’s health. and ethnic minorities.
In addition to changes in individual behaviour, broader
Source: World Health Organization; Global Research Network on Urban Health Equity.
Urban Disparities
On average, children in urban areas are national averages are disaggregated, it In Benin, Pakistan, Tajikistan and
more likely to survive infancy and early becomes clear that many children living in Venezuela (Bolivarian Republic of), the
childhood, enjoy better health and have urban poverty are clearly disadvantaged education gap between the richest 20
more educational opportunity than their and excluded from higher educa- per cent and the poorest 20 per cent is
counterparts in rural areas. This effect is tion, health services and other benefits greater in urban than in rural areas. The
often referred to as the ‘urban advantage’. enjoyed by their affluent peers. gap is widest in Venezuela, where pupils
from the richest urban families have, on
Nevertheless, the scale of inequality The figures below, called ‘equity trees’, average, almost eight years more school-
within urban areas is a matter of great illustrate that, while vast disparities exist in ing than those from the poorest ones,
concern. Gaps between rich and poor in rural areas, poverty also can severely limit compared with a gap of 5 years between
towns and cities can sometimes equal or a child’s education in urban areas – in some the wealthy and poor in rural areas. In
exceed those found in rural areas. When cases, more so than in the countryside. Benin, Tajikistan and Venezuela, children
Benin Pakistan
14 14
12 12
10 10
Tajikistan Tajikistan urban richest 20% female
Venezuela (Bolivarian Venezuela (Bolivarian male
male
Average years of schooling
Benin rural
Benin
4 4
male
rural male
male
male urban poorest 20%
Education poverty rural poorest 20% Education poverty female
2 2 rural poorest 20%
urban poorest 20%
female
female female
Source: UNICEF analysis based on UNESCO Deprivation and Marginalization in Education database (2009) using household survey data: Benin (DHS, 2006);
Pakistan (DHS, 2007); Tajikistan (MICS, 2005); Venezuela (Bolivarian Republic of) (MICS, 2000).
6 STATE OF
THE STATE OF THE
THEWORLD’S
WORLD’SCHILDREN
CHILDREN2012
2012
from the poorest urban households are of the population receive less than two they receive less than six years of educa-
likely to have fewer years of school- years of schooling, compared with three tion, compared with almost nine years for
ing not only than children from wealthier to four years for their male counterparts poor girls in rural areas. But the gender
urban households but also than their and about nine years for the richest boys gap is reversed in Venezuela, where the
rural counterparts. in urban and rural settings. In Pakistan, poorest boys in urban areas receive the
the difference in educational attain- least education – less than three years
Some disparities transcend location. ment between the poorest boys and girls of schooling, compared to four and a
Girls growing up in poor households are is about three years in rural areas and half years for the poorest girls in urban
at a great disadvantage regardless of about one year in urban areas. settings and about six and a half years for
whether they live in urban or rural areas. the poorest boys and girls in rural areas.
In Benin, girls in urban and rural areas The gender gap is more pronounced for
who come from the poorest 20 per cent poor girls in urban Tajikistan. On average,
Republic of)
male Republic of)
8 8
male
Education poverty Education poverty
2 2
Childrenin
Children in an
an increasingly
increasingly urban world 7
© UNICEF/NYHQ2006-1335/Claudio Versiani
Children juggle to make money on the streets of Salvador, capital of the eastern state of Bahia, Brazil.
Cities are not homogeneous. Within them, and partic- Second, development solutions must identify and
ularly within the rapidly growing cities of low- and remove the barriers to inclusion that prevent marginal-
middle-income countries, reside millions of children ized children and families from using services, expose
who face similar, and sometimes worse, exclusion and them to violence and exploitation, and bar them from
deprivation than children living in rural areas. taking part in decision-making. Among other neces-
sary actions, births must be registered, legal status
In principle, the deprivations confronting children conferred and housing tenure made secure.
in urban areas are a priority for human rights-based
© UNICEF/INDA2011-00105/Graham Crouch
priorities of children must be maintained in urban plan-
ning, infrastructure development, service delivery and
broader efforts to reduce poverty and disparity. The
international Child-Friendly Cities Initiative provides
an example of the type of consideration that must be
given children in every facet of urban governance.
Figure 1.4. Urban populations are growing fastest in Asia and Africa
World urban population 1950, 2010, 2050 (projected)
1%
Africa
Asia
Europe
1%
atin America
L 6%
and the Caribbean
North America 10% 20%
Pacific
8% 12%
9%
14%
1% 5%
15% 15%
50%
54%
10% 31%
38%
© UNICEF/NYHQ2008-1027/Christine Nesbitt
Children’s rights
in urban settings
Children whose needs are greatest are also those who unregistered at birth – and about half the children in
face the greatest violations of their rights. The most the urban areas of sub-Saharan Africa and South Asia
deprived and vulnerable are most often excluded from are unregistered. This is a violation of Article 7 of the
progress and most difficult to reach. They require Convention on the Rights of the Child. The invisibil-
particular attention not only in order to secure their ity that derives from the lack of a birth certificate or an
entitlements, but also as a matter of ensuring the official identity vastly increases children’s vulnerability
realization of everyone’s rights. to exploitation of all kinds, from recruitment by armed
groups to being forced into child marriage or hazard-
Children living in urban poverty have the full range ous work. Without a birth certificate, a child in conflict
of civil, political, social, cultural and economic rights with the law may also be treated and punished as an
recognized by international human rights instruments. adult by the judicial system.1 Even those who avoid
The most rapidly and widely ratified of these is the these perils may be unable to access vital services and
Convention on the Rights of the Child. The rights of opportunities – including education.
every child include survival; development to the fullest;
protection from abuse, exploitation and discrimina- Obviously, registration alone is no guarantee of access
tion; and full participation in family, cultural and social to services or protection from abuse. But the obliga-
life. The Convention protects these rights by detailing tions set out by the Convention on the Rights of the
commitments with respect to health care, education, Child can be easily disregarded when whole settle-
and legal, civil and social protection. ments can be deemed non-existent and people can,
in effect, be stripped of their citizenship for want
All children’s rights are not realized equally. Over of documentation.
one third of children in urban areas worldwide go
© UNICEF/NYHQ2009-0609/Shehzad Noorani
child rights
Inadequate living conditions are among the most
pervasive violations of children’s rights. The lack of
decent and secure housing and such infrastructure as
water and sanitation systems makes it so much more
difficult for children to survive and thrive. Yet, the
attention devoted to improving living conditions has
not matched the scope and severity of the problem.
Half the world’s population now lives in cultural barriers, like gender and ethnic- search for regional peace, we must set
cities. Throughout history, urban life, so ity, that deny children from the slums aside our anger and angst and give them
concentrated with humanity, has been the chance to enrol in and complete the childhoods they deserve, childhoods
a catalyst for trade, ideas and opportuni- primary school. Education is pushed out we expect for our own children, filled with
ties, making cities engines of economic of reach because there are not enough happy memories and equal opportunities.
growth. Today, living in a city is widely public schools or the costs are too high.
regarded as the best way to find pros- Religious groups, non-governmental In a few Arab countries, the fates of
perity and escape poverty. Yet hidden organizations and entrepreneurs try to fill disadvantaged urban children are being
inside cities, wrapped in a cloak of statis- the gap but struggle without government rewritten. In Morocco, the government
tics, are millions of children struggling to support or regulation. As the best chance programme ‘Cities without Slums’
survive. They are neither in rural areas nor to escape their parents’ destinies eludes hopes to raise the standards of nearly
in truly urban quarters. They live in squa- these children, the cycle of destitution 300,000 homes. By engaging banks
lor, on land where a city has outpaced spins on. and housing developers, a ‘triple win’
itself, expanding in population but not scenario is possible for poor people,
in vital infrastructure or services. These In the Arab world the facts are clear: the government and the private sector.
are children in slums and deprived neigh- More than one third of the urban Jordan, too, is making strides. Amman is
bourhoods, children shouldering the many population lives in informal settlements one of the region’s leading child-friendly
burdens of living in that grey area between and slums. These environments are cities, with over 28,000 students partici-
countryside and city, invisible to the hazardous to children; a lack of adequate pating in children’s municipal councils to
authorities, lost in a hazy world of statisti- sanitation and drinkable water poses a prioritize their needs, rights and interests.
cal averages that conceal inequality. major threat to their well-being. In some The results have been impressive: parks,
less developed Arab countries, over- libraries, community spaces, educational
The contrast could not be more ironic. crowding in makeshift houses further support for children who dropped out of
Cities, where children flourish with good aggravates the precarious health condi- school, campaigns against violence and
schools and accessible health care, are tions of these vulnerable families. abuse, and information and communica-
where they also suffer greatly, denied tion technology centres for the deaf.
their basic human rights to an educa- For Palestinian children, city life can be
tion and a life of opportunity. Side by a grim life. Too often, it represents guns Yet for Arab children – for all children – to
side, wealth juxtaposed against poverty, and checkpoints, fear and insecurity. thrive, nations have to work together. We
nowhere else is the iniquity of inequity as Yet their greatest hope is their national have to share resources, adopt and adapt
obvious as in a city. pride: a deep-seated belief in education, successful initiatives from around the
which they know is essential for build- globe and encourage our private sectors
Over the course of a decade, the state of ing a life and rebuilding their country. Yet, to engage with disadvantaged families so
the world’s urban children has worsened. since 1999, across Occupied Palestinian we can catch those falling through the
The number of people living in slums Territory, the number of primary-school- cracks. In cities across the world, chil-
has increased by over 60 million. These aged children who are out of school has dren out of reach are too often out of
are mothers and fathers, grandmothers leapt from 4,000 to 110,000, a staggering sight. If we are to raise their hopes and
and grandfathers, sons and daughters, 2,650 per cent increase. In Gaza, among their prospects, we have to dig deep into
scratching out a life in shantytowns the the world’s most densely populated areas, the data, unroot entrenched prejudices
world over. With the direct disadvan- access to and quality of education have and give every child an equal chance at
tages of urban poverty – disease, crime, deteriorated rapidly. For the sake of these life. Only in this way can we truly advance
violence – come indirect ones, social and children’s futures and of the all-important the state of all the world’s children.
The Convention on the Rights of the Child, adopted in 1989, Furthermore, “a mentally or physically disabled child should
was the first international treaty to state the full range of civil, enjoy a full and decent life, in conditions which ensure
political, economic, social and cultural rights belonging to dignity, promote self-reliance and facilitate the child’s active
children. The realities confronting children can be assessed participation in the community” (Article 23). This extends to
against the commitments to which it holds States parties. the right to special care, provided free of charge whenever
possible, and effective access to education, training, health
Legally binding on States parties, the Convention details care, rehabilitation services, recreation opportunities and
universally recognized norms and standards concerning the preparation for employment.
protection and promotion of the rights of children – everywhere
and at all times. The Convention emphasizes the complementar- Participation
ity and interdependence of children’s human rights. Across its One of the core principles of the Convention is respect for
54 articles and 2 Optional Protocols, it establishes a new vision and consideration of the views of children. The document
of the child – one that combines a right to protection through recognizes children’s right to freely express their views in all
the State, parents and relevant institutions with the recognition matters affecting them and insists that these views be given
that the child is a holder of participatory rights and freedoms. due weight in accordance with the age and maturity of the
All but three of the world’s nations – Somalia, South Sudan and children voicing them (Article 12). It further proclaims chil-
the United States of America – have ratified the document. dren’s right to freedom of all forms of expression (Article 13).
This broad adoption demonstrates a common political will to Children are entitled to freedom of thought, conscience and
protect and ensure children’s rights, as well as recognition religion (Article 14), to privacy and protection from unlawful
that, in the Convention’s words, “in all countries in the world, attack or interference (Article 16) and to freedom of association
there are children living in exceptionally difficult conditions, and peaceful assembly (Article 15).
and that such children need special consideration.”
Social protection
The values of the Convention stem from the 1924 Geneva The Convention acknowledges the primary role of parents
Declaration of the Rights of the Child, the 1948 Universal or legal guardians in the upbringing and development of
Declaration of Human Rights and the 1959 Declaration of the the child (Article 18) but stresses the obligation of the State
Rights of the Child. The Convention applies to every child, to support families through “appropriate assistance,” “the
defined as every person younger than 18 or the age of major- development of institutions, facilities and services for the
ity, if this is lower (Article 1). The Convention also requires care of children” and “all appropriate measures to ensure
that in all actions concerning children, “the best interests of that children of working parents have the right to benefit from
the child shall be a primary consideration,” and that States child-care services and facilities for which they are eligible.”
parties “ensure the child such protection and care as is
necessary for his or her well-being” (Article 3). Of particular relevance in the urban context is the recognition
of “the right of every child to a standard of living adequate
Every child has the right to be registered immediately after birth for the child’s physical, mental, spiritual, moral and social
and to have a name, the right to acquire a nationality and to development” (Article 27). The responsibility to secure these
preserve her or his identity and, as far as possible, the right to conditions lies mainly with parents and guardians, but States
know and be cared for by her or his parents (Articles 7 and 8). parties are obliged to assist and “in case of need provide
material assistance and support programmes, particularly
Non-discrimination with regard to nutrition, clothing and housing.” Children have
States parties also take on the responsibility to protect children the right to benefit from social security on the basis of their
against discrimination. The Convention commits them to circumstances (Article 26).
respecting and ensuring rights “to each child within their juris-
diction without discrimination of any kind, irrespective of the Health and environment
child’s or his or her parent’s or legal guardian’s race, colour, sex, States parties are obliged to “ensure to the maximum extent
language, religion, political or other opinion, national, ethnic or possible the survival and development of the child” (Article
social origin, property, disability, birth or other status” (Article 2). 6). Each child is entitled to the “enjoyment of the highest
Children belonging to ethnic, religious or linguistic minorities attainable standard of health and to facilities for the treat-
and those of indigenous origin have the right to practise their ment of illness and rehabilitation of health” (Article 24). This
own culture, religion and language in the community (Article 30). includes child care; antenatal, postnatal and preventive
Nepal
Maternal and newborn health
Honduras
premium for health care, as confirmed by studies in Source: WHO estimates and DHS, 2005–2007. Countries were selected based
Bangladesh, India, Kenya and elsewhere.14 on availability of data.
Kenya
A study of the National Family Health Survey (NFHS-3)
in eight cities in India from 2005 to 2006 found that Sierra Leone
Rapid urbanization has been taking are exactly where most local women their height-for-age index falls more
place in Kenya – as in much of sub- go for maternal and child health care – than two standard deviations below the
Saharan Africa – largely in a context seeking better-quality options only once median of the reference population; they
of weak economic development and complications occur. In contrast to public are severely stunted if the index is more
poor governance. As a result, local and services, which seldom extend to infor- than three standard deviations below the
national authorities have not been able mal settlements, these private facilities median. Stunting prevalence is a useful
to provide decent living conditions and are perceived as friendly, accessible and tool for comparisons within and between
basic social services sufficient to meet trustworthy, perhaps because they invest countries and socio-economic groups.
the needs of a growing urban popula- more time in building relationships with
tion. Between 1980 and 2009, the number patients. Only a small proportion of the Figure 2.3 portrays the magnitude of
of people living in Nairobi, the capital, urban poor has access to more reliable inequities in child undernutrition by
increased from 862,000 to about 3.4 million. maternal health care services, including comparing average stunting levels for
Estimates (2007) indicate that around those offered at clinics and hospitals run urban Kenya against data collected
60 per cent live in slums covering only by missionaries and non-governmental between 2006 and 2010 in the Korogocho
5 per cent of the city’s residential land. organizations. and Viwandani slum settlements. The
Moreover, emerging evidence reveals study covers all women who gave birth in
that the urban population explosion in Urban child undernutrition the area. The children’s measurements
the region has been accompanied by In developing countries, child under- were taken periodically up to 35 months
increasing rates of poverty and poor nutrition remains a major public health of age.
health outcomes. The incidence of child concern. Both a manifestation and a
undernutrition, morbidity and mortal- cause of poverty, it is thought to contribute As the graph demonstrates, the preva-
ity has been shown to be higher in slums to over a third of under-five deaths glob- lence of stunting among children living
and peri-urban areas than in more privi- ally. Insufficient nutrition is one of a wide in slum areas increases sharply from
leged urban settings or, sometimes, even range of interlinked factors forming the less than 10 per cent during the first few
rural areas. so-called poverty syndrome – low income, months of life to nearly 60 per cent in
large family size, poor education and the group aged 15–17 months, and then
Access to health services limited access to food, water, sanitation remains at that level. In urban Kenya
In Nairobi slums, public provision of and maternal and child health services. overall, the prevalence of undernutri-
health services is limited. A study tion reaches a maximum of 35 per cent
conducted in 2009 shows that out of Stunting, underweight and wast- among children aged 15–17 months,
a total of 503 health facilities used by ing – measured by height-for-age, then declines to around 25 per cent. The
residents of three slum communities weight-for-age and weight-for-height, gap between the poor (here, slum resi-
(Korogocho, Viwandani and Kibera), only respectively – are the three most dents) and the non-poor in Kenya widens
6 (1 per cent) were public, 79 (16 per frequently used anthropometric indi- from this point. For example, among chil-
cent) were private not-for-profit, and 418 cators of nutritional status. Stunting is dren above 15 months, the prevalence of
(83 per cent) were private for-profit. The considered the most reliable measure stunting stands at around 57 per cent in
last category largely consists of unli- of undernutrition, as it indicates recur- the slums and nearly 28 per cent in urban
censed and often ramshackle clinics rent episodes or prolonged periods of Kenya as a whole. Separate analysis (not
and maternity homes, with no work- inadequate food intake, calorie and/or illustrated in Figure 2.3) reveals that the
ing guidelines or standard protocols for protein deficiency or persistent or recur- prevalence of stunting among the urban
services. Yet these substandard facilities rent ill health. Children are stunted if rich is close to 21 per cent, suggesting
Figure 2.4. HIV is more common in urban areas and more prevalent among females
HIV prevalence among young women and men aged 15–24 in urban and rural areas in selected sub-Saharan African countries
30%
25% Rural
Urban
20%
15%
10%
5%
0%
female male female male female male female male female male female male
Lesotho Malawi Mozambique Swaziland Zambia Zimbabwe
Source: Lesotho, DHS 2009; Malawi, DHS 2004; Mozambique, AIS 2009; Swaziland, DHS 2006–2007; Zambia, DHS 2007; Zimbabwe, DHS 2005–2006.
Countries were selected based on availability of data.
For 10 years, I have been telling India poor access to clean water, poor access on top of the other, three or four stories
the life-saving message that every child to toilets, poor breastfeeding rates and high. The immunization teams then mark
should take two drops of oral polio poor nutrition. those corrugated iron walls with chalk,
vaccine every time it is offered. so that the monitors who will follow in the
And it is working. Polio now is a virus of the poorest, coming days can see which houses have
making its final stand in the most forgot- been reached – and which children have
Today, India stands on the brink of ten places, among the most forgotten been immunized. Additional teams return
eradicating polio – arguably the greatest people. Reaching these people – the to cover any children who were missed.
public health achievement in its history. slum dwellers, the nomads, the migrants,
When the polio eradication campaign the brick kiln workers, the families of Mumbai, India’s financial capital and
started, India was reporting around 500 construction workers living beside the home to its film industry, is among the
polio cases per day. Since then, more plush high-rises they build (for a dollar a world’s biggest and richest cities. It is
than 4 million children have been saved day) under a sheet of plastic – is one of also believed to contain the highest
from paralysis or death. All our hard work the greatest challenges in public health. proportion and largest absolute number
is paying off. But the simple truth is that The polio eradication programme is of slum dwellers. By some estimates,
as long as polio exists anywhere in the actively following a detailed ‘underserved between 100 and 300 new families arrive
world, the threat will persist. strategy’ to target India’s hardest-to- each day in search of work. All too often,
reach people, including those living in migrant families of low socio-economic
I am immensely proud that independent urban slums, in order to raise immunity status find themselves in a slum. All too
studies have shown that the ‘Every child, among those populations at highest risk. often, these arrivals are never tracked,
every time’ slogan is one of India’s most It is not an easy task – literally millions never chartered, never given a name. All
recognizable messages. I am even more of migrant families move back and forth too often, the hardest-to-reach children
proud that Indian parents have answered across the country each week, and in the in our country are living right under
that call. During two annual National traditionally polio-endemic states of Uttar our noses.
Immunization Days, normally held each Pradesh and Bihar, around 750,000 chil-
January and February, approximately dren are born each month. In order to India’s polio eradication programme
170 million children under 5 are vacci- eradicate polio in India, it is essential to demonstrates that it is possible to
nated by immunization teams going reach and immunize every last child. And ensure equity in the availability of health
door-to-door to every house in the coun- in the swelling slums of India’s heaving services in even the poorest, most
try. Then, every month from March to cities, every last child is hard to find. densely populated environments. It
December, almost all children under the proves that you can find every last child
age of 5 in India’s two traditionally polio- Consider Dharavi, one of the largest in the city. And it means that in Mumbai,
endemic states and highest-risk areas slums in my home town of Mumbai – while the children of the slums continue
are vaccinated during polio immuniza- home to a million people in just 3 square to face many threats, polio need not be
tion campaigns – campaigns that reach kilometres. Here, poliovirus immunization one of them.
40–80 million children a year. Pause for teams must follow carefully developed
a second to examine those numbers. micro-plan maps, walking single file
Then consider what characterizes the along the tiny lanes, scrambling up rick-
highest-risk areas for poliovirus transmis- ety ladders to reach the children living
sion: high-density living, poor sanitation, in corrugated iron homes stacked one
Amitabh Bachchan is one of the most prominent figures in the history of Indian cinema. He has won 4 National Film Awards – 3 in the Best Actor category –
and 14 Filmfare Awards. He has also worked as a playback singer, film producer and television presenter and was an elected member of the Indian
Parliament (1984–1987). He has been India’s polio eradication ambassador since 2002.
Figure 2.5. In urban areas, access to improved water and sanitation is not keeping pace with population growth
World population gaining access to improved drinking water and sanitation relative to population increase, 1990–2008
P
opulation
gaining access
723 to improved
Rural
450 drinking water
370 P
opulation
gaining access
to improved
1,052
sanitation
Urban P
opulation
813
growth
1,089
Washing hands with soap and water at an elementary school in Aceh Besar District, Aceh Province, Indonesia.
Water, sanitation and hygiene people are forced to walk to collect water from other
Article 24 of the Convention on the Rights of the Child neighbourhoods or to buy it from private vendors.45 It is
commits States parties to strive to ensure the high- common for the urban poor to pay up to 50 times more
est attainable standard of health for every child. This for a litre of water than their richer neighbours, who
extends to providing clean drinking water and elimi- have access to water mains.46 Without sufficient access
nating the dangers of environmental pollution. to safe drinking water and an adequate water supply
for basic hygiene, children’s health suffers. Improving
Unsafe water, poor sanitation and unhygienic condi- access remains vital to reducing child mortality
tions claim many lives each year. An estimated 1.2 and morbidity.
million children die before the age of 5 from diarrhoea.
Poor urban areas where insufficient water supply The urban population as a whole has better access to
and sanitation coverage combine with overcrowded sanitation than the rural population, but here, too,
conditions tend to maximize the possibility of faecal coverage is failing to keep up with urban population
contamination.43 growth. In consequence, the number of urban dwellers
practising open defecation increased from 140 million
Globally, urban dwellers enjoy better access to im- to 169 million between 1990 and 2008.47 The impact
proved drinking water sources (96 per cent) than do of this practice in densely populated urban settlements
people living in rural areas (78 per cent). Even so, is particularly alarming for public health. Congested
improved drinking water coverage is barely keeping and unsanitary conditions make urban slums partic-
pace with urban population growth.44 And access to ularly high-risk areas for communicable diseases,
an improved water source does not always guarantee including cholera.
adequate provision. In the poorest urban districts, many
Rwanda
Burundi
Education
Mali
In Article 28 of the Convention on the Rights of the
Child, States parties recognize children’s right to educa-
Democratic Republic of the Congo
tion and commit to “achieving this right progressively
Benin
and on the basis of equal opportunity.”
Guinea-Bissau
Zambia
Children in urban settings are generally considered
to have an educational advantage. They are better off
Nigeria
across a range of statistical indicators, more likely to
United Republic of Tanzania benefit from early childhood programmes, and more
Cameroon likely to enrol in and complete primary and second-
ary school.48 As in other areas of social provision,
Guinea
however, the overall statistics can be misleading. In
Senegal
reality, urban inequities profoundly undermine chil-
Côte d’Ivoire dren’s right to education.49 In urban areas blighted by
Swaziland
poverty, early childhood programming is often nota-
ble for its absence. This is lamentable because the first
Togo
few years have a profound and enduring effect on the
Malawi rest of a person’s life and, by extension, the lives of so
Ethiopia many others.
Uganda
Some of the 4,000 children who attend Halit Coka Compulsory and High School, built for 1,000 students in Bathore, once a squatter settlement and now
the largest suburb of Tirana, Albania.
Establishing good early childhood programmes in 2008, 67 million primary-school-aged children were
poor urban communities is essential to supporting still out of school, 53 per cent of them girls.52
children’s survival, growth and learning. Early child-
hood programmes contribute to children’s cognitive, Primary education is generally more readily available
social and emotional development and promote their in urban than in rural areas but remains beyond the
health, nutrition and hygiene. In addition, they can reach of many children growing up in poverty – espe-
free mothers and other female caregivers from their cially in slums, where there is often little or no public
traditional roles, enabling them to participate in the schooling. Families often face a choice between paying
public sphere. Yet even where such programmes exist,
not all children benefit. While 25 per cent of children
© UNICEF/NYHQ2011-1096/Kate Holt
in Egypt’s urban areas attended kindergarten in 2005–
2006, compared with 12 per cent in rural areas, only
4 per cent of those from the poorest 20 per cent of
urban households were able to access this service.51
Children from impoverished urban backgrounds have
been found to be similarly disadvantaged in a number
of other countries.
Primary education
Similar gaps – reflecting inequalities in parental income,
gender and ethnicity, among other factors – persist in
A girl receives speech therapy in Chisinau, Republic of Moldova, as her
grade school, despite the progress many countries have mother looks on.
made in pursuing universal primary education. As of
100%
Primary urban non-slum
P
rimary urban slum
80% S
econdary urban non-slum
S
econdary urban slum
60%
40%
20%
0%
Kenya (22% urban) Bangladesh (28% urban) India (30% urban) Ghana (51% urban)
Source: Kenya, DHS 2003; Bangladesh, DHS 2007; India, DHS 2005–2006; and Ghana, DHS 2003. Countries were selected for illustrative purposes.
for their children to attend overcrowded private are already under strain may have great difficulty in
schools of poor quality or withdrawing their children coping with an influx of displaced children. Evidence
from school altogether. suggests that displacement severely disrupts chil-
dren’s education – and again, the worst affected are
Even in countries where primary schooling is free, the often those who were already marginalized because of
ancillary costs can leave people who live in poverty at a poverty, gender, ethnic identity or other factors.55
disadvantage. Students may have to purchase uniforms
and classroom supplies or pay fees to take exams, and Children from poor urban neighbourhoods are among
these taken together are often expensive enough to the least likely to attend school. A survey in Delhi, India,
prevent children from attending school. While parents found a primary school attendance rate of 54.5 per
in Dhaka, Bangladesh, spend an average of 10 per cent cent among children living in slums in 2004–2005,
of household income per child on schooling costs, this compared with 90 per cent for the city as a whole.56
rises to 20 per cent in the poorest families. A recent In Bangladesh, according to 2009 data, the differences
survey of Sao Paulo, Brazil; Casablanca, Morocco; were even more pronounced at the secondary level:
and Lagos, Nigeria, showed that families in the lowest 18 per cent of children in slums attended secondary
income quintile spent more than a quarter of house- school, compared with 53 per cent in urban areas as
hold income on schooling.53 a whole and 48 per cent in rural areas.57 Even where
progress is made, it cannot be taken for granted.
Marginalized groups, including children living or While enrolment improved in the rural and non-
working on the street, migrant children and the chil- slum urban areas of the United Republic of Tanzania,
dren of refugees and internally displaced persons, face Zambia and Zimbabwe in the late 1990s, it worsened
particular challenges. Until recently in China’s cities, in urban slums.58
for example, migrants who were not officially regis-
tered had difficulty sending their children to school.54 The quality of available schooling options in poor
And all too often, children who are seen as different urban areas is another issue to consider. While
– because of poverty, language or gender, for example – data tend to focus on access, enrolment and reten-
face discrimination. tion, these are linked to the perceived quality and
benefits of available education. Overcrowding and a
Refugees and internally displaced people often live in lack of appropriate facilities such as toilets are among
informal settlements in urban areas, and schools that the factors that undermine the quality of education.59
© UNICEF/NYHQ2011-0219/Sebastian Rich
of the child.” Article 32 recognizes children’s right to
be protected from economic exploitation and hazard-
ous work. Article 34 targets sexual exploitation and
Article 35, trafficking.
Child trafficking
At any given time, nearly 2.5 million people are in
forced labour as a result of trafficking – 22 to 50 per
cent of them children.60 Child trafficking is frequently
hidden, denied or ignored, making comprehensive data
difficult to obtain. Some forms take place mainly in
urban areas: trafficking for sex work, for example, and
trafficking that targets children who live or work on
city streets.
Child labour
Child domestic workers can also suffer from psycho-
Even in the absence of trafficking, many children are logical problems. Research in Kenya, for example,
forced to work in order to survive. Around the world, found that they were more likely than other children
an estimated 215 million boys and girls aged 5–17 to experience insomnia, bed-wetting and depression,
were engaged in child labour in 2008, 115 million of among other conditions.66
them in hazardous work.65
The eight Millennium Development Goals (MDGs) cover without concerted action to eradicate poverty and
a spectrum of issues, from poverty and hunger to educa- hunger (MDG 1); achieve universal primary education
tion, child survival and maternal health, gender equality, (MDG 2); promote gender equality and empower women
combating HIV/AIDS and building a global partnership for (MDG 3); reduce child mortality (MDG 4); improve mater-
development. Progress towards achieving the goals is nal health (MDG 5); combat HIV/AIDS (MDG 6); or create
measured against 21 specific targets. a global partnership for development (MDG 8).
MDG 7 contains the commitment to ensure environmental Evidence suggests that national approaches to slums are
stability. One of its urban facets, Target 11, aims to have improving as countries move away from negative policies
achieved a significant improvement in the lives of at least such as neglect, forced eviction or involuntary resettle-
100 million slum dwellers by 2020. This is also known as ment towards more positive tactics such as community
the ‘Cities without Slums’ initiative. In addition to envi- engagement, slum upgrading and rights-based policies.
ronmental concerns and a specific focus on urban slums, Nevertheless, the number of slum dwellers worldwide
MDG 7 also contains a commitment to halve, by 2015, the has increased by 60 million since Target 11 was estab-
proportion of people without sustainable access to safe lished in 2000.
drinking water and basic sanitation.
Slums are the physical manifestation of the urbanization
Although one of the targets of MDG 7 is dedicated of poverty. Growing numbers of urban dwellers are poor,
specifically to slum dwellers, the goals should be seen and inequality in the urban sphere shows no signs of
as a continuum of development priorities. The lives of abating. Future international targets will have to take into
people in the world’s slums cannot improve substantially account the expanding scale of the problem.
© UNICEF/NYHQ2007-2316/Michael Kamber
Urban
challenges
This chapter examines some of the phenomena shaping deliberate response intended to deter future migra-
the lives of children in urban areas, from their reasons tion. Migrants, especially those without documents,
for moving to the city and their experience of migration may be denied public services, social protection and
to the challenges of getting by in the face of economic even emergency health care. Institutionalized exclu-
shocks, violence and disasters. sion can take the form of registration requirements
for migrant workers – an ostensible means of proffer-
ing services that, in practice, often serves the opposite
Migrant children purpose. Rather than making such essentials as school-
It has long seemed as if cities had a magical power to ing available to migrant families, these requirements
draw people in with bright lights and the promise of often have the effect of denying such services to those
advancement. Images of people moving from rural to not registered,4 especially where the process or cost of
urban areas endure in the collective imagination, and registration is prohibitive.
migration continues to play an important role in many
regions. Rural-to-urban migration is pronounced in Most child migrants move with their families,5 accom-
West Africa,1 for instance, and international migra- panying parents or caregivers seeking employment or
tion remains a major factor in Europe, Asia and opportunity. Almost a tenth of China’s child popula-
North America.2 tion, or 27.3 million children, took part in internal
migration with their parents in 2008.6 A significant
Historically, access to resources in urban areas has number of children and young people, however, move
not been equitable. Every place has its own pattern of within countries on their own.7 A recent analysis of
vulnerability, stemming from accumulated and current census and household data from 12 countries found
political and social prejudices.3 New arrivals may be that one in five migrant children aged 12–14 and half
pushed to the margins of urban society; this may be a of those aged 15–17 had moved without a parent.8
Urban challenges 35
© UNICEF/NYHQ2008-0453/Adam Dean
Queuing for food at a camp for people displaced by the 2008 earthquake in the city of Mianyang, Sichuan Province, China.
Children and young people frequently follow established separate identity – effectively declaring independence.12
patterns of migration. In West Africa and South Asia, Be it forced or voluntary, with adult caregivers or alone,
where rates of independent child migration are partic- migration entails risks that require age-appropriate
ularly high,9 most child migrants leave home between measures to protect the children involved.
the ages of 13 and 17. Many of these children grow
up in impoverished rural areas where it is common Once in the city, children who moved to help their
to travel to seek work in order to supplement family families can find that participation in the urban
income, whether for part of each year, during lean economy weakens the bonds between them and their
periods or for longer durations.10 At least 4 million parents.13 Indeed, the act of leaving home may even
children are thought to migrate seasonally, whether by be seen as an abandonment of family duties and thus
themselves or with their families, in India alone.11 may cause conflict with parents. And all too often,
young people who arrive in urban centres with hopes
Like adults, children migrate in response to a combi- of educational advancement find it unattainable
nation of push and pull factors. For many, migration because of work commitments, as separate studies in
is an attempt to secure a better life, whether in terms Bangladesh and Ghana have confirmed.14
of economic or educational opportunities, or simply to
escape poverty. Others relocate because of family circum- The quality of schooling also can be a cause for
stances, such as the loss of a parent, or to escape conflict concern. In Turkey as elsewhere, schools in poor quar-
or natural disasters and the upheaval and food shortages ters and on the urban periphery, where most migrants
that accompany them. An unstable or difficult family settle, struggle with overcrowding and a lack of
environment often plays a role. Children may be forced resources. To this is added the challenge of accommo-
to leave owing to neglect or abuse from their caregivers. dating an influx of students from diverse cultures who
And in some cases, leaving is a way of marking out a speak different languages.15
In 2005, governments in Central and towns and larger villages. What sets the because the family struggled to pay the
Eastern Europe proclaimed the Roma situation in urban settings apart, here bills. Growing up in a damp space, with-
Decade of Inclusion and committed as in the wider region, is the separation out gas to cook food or water to wash,
themselves to “eliminating discrimina- of Roma from the rest of the municipal just a few blocks away from the glossy
tion and closing the unacceptable gaps population, with the Roma population commercial boulevards of Bucharest
between Roma [people] and the rest of living in de facto ‘ghettos’. The problem – this is the brutal reality of two neigh-
society.” With the clock running down of ‘ghettoization’ is a clear physical mani- bouring worlds.
to the Decade’s conclusion in 2015, this festation of exclusion. Its roots date back
effort to right historical inequalities in to the mid-1800s, when laws were passed Urban poverty is especially difficult for
such key areas as education, gender freeing Roma from centuries of slavery. children, who have little control over
and health has brought modest results. Without any policies to promote and ease their surroundings or level of affluence.
Roma children continue to have substan- integration, freed Roma settled at the Many find it impossible to attend school,
tially lower vaccination coverage, with margins of urban areas – essentially, on and those who do attend struggle to do
appalling consequences. When Bulgaria no man’s land. Through my work I have well with limited support. Roma children
experienced an outbreak of measles in seen that Roma communities continue in Romania have much lower enrolment
2009, 90 per cent of all cases occurred to be excluded from the development rates at all levels of education, starting
among the ethnic Roma community. plans of cities that have expanded and with preschool; many are unnecessar-
encircled their neighbourhoods. Roma ily placed in special education. In 2005,
Romania, home to more than half a communities remain isolated – many only 46 per cent of the Roma popula-
million Roma according to the latest offi- are not connected to public utilities. tion aged 12 and above had spent more
cial data (other estimates run as high as The absence of permanent housing, than four years in school (compared with
2.8 million), illustrates the difficulties and combined with a lack of birth or identity 83 per cent of the general population),
opportunities involved in efforts to elimi- documents, can significantly limit access and of those only 13 per cent acquired at
nate disparities and promote inclusion. In to health care, education and employ- least some secondary education (63 per
2001, the Government adopted a national ment. Evictions frequently occur without cent among the general population).
strategy to improve the situation of Roma warning, reinforcing this segregation.
throughout the country. Ten years on, only The lucky ones find non-governmental
13 per cent of local governments have What is life like for a child in a Bucharest organizations that provide counselling,
implemented specific measures for Roma ghetto? Consider the case of Laurentiu, tutoring, homework help and a space
communities. Progress towards social a 16-year-old in the Ferentari district, in which children can discuss prob-
inclusion has been slow from the outset known for its large Roma population, lems, gain confidence and improve their
and was further hampered by the global its derelict buildings, its poverty and marks, often in preparation for the crucial
economic crisis, which hit the region in large numbers of children out of school. 8th grade final exam, a stepping stone
2008. Many municipalities have cut social After Laurentiu’s father died, his mother to high school or vocational studies. The
spending amid rising unemployment. abandoned him, and he was placed in Roma Education Fund is one organization
a state institution. He now lives with working to make a difference in the lives
Poverty affects Roma communities in his 70-year-old grandmother and his of some 5,000 Roma children and youth in
both urban and rural Romania; the poor- five brothers in an apartment that has Romania. But there are so many more like
est are clustered mainly in mid-size been disconnected from water and gas Laurentiu. So much remains to be done.
Eugen Crai is the country director of the Roma Education Fund in Bucharest, Romania. He holds a master’s degree in law from McGill University, Canada,
and specializes in human rights law and anti-discrimination legislation, as well as minority rights advocacy and education policy. His professional career
centres on Roma communities – over the past 14 years he has worked on the first European Union Phare Project for the Improvement of the Roma Situation
in Romania and has also served as education officer and social policy specialist at UNICEF Romania.
Urban challenges 37
Agents, not victims
Children play no part in creating social hierarchies, actual experiences have been negative. Many see migration
classes or castes. They are born into deeply unequal as a step towards taking material responsibility for them-
societies and live out their lives hampered (and, occa- selves and as an opportunity for superior education.
sionally, aided) by societal perceptions, conventions and
stereotypes. It is easy, therefore, to regard them simply as Work, too, can have an empowering effect, particularly
victims of forces beyond their control. But consider their if it provides vital resources for survival. While child
motives and actions as migrants, and it becomes appar- labour is too often premature, exploitative, dangerous
ent that children also act as agents of their own destiny. and abusive, it is important to recognize that, especially
for older children, appropriate work can make a signifi-
A teenager’s decision to migrate or seek work may be an cant contribution to development by building self-esteem,
empowering experience – an attempt to reach objectives or teaching skills and helping children cope with poverty.
assert independence. Indeed, for all the dangers and diffi- The Convention on the Rights of the Child recognizes that
culties children face, studies suggest that most perceive children should have increasing autonomy, in line with
their migration as having been positive – even when their their evolving capacities.
Children who migrate unaccompanied by adults are lack the legal right to urban residence and may there-
particularly vulnerable to exploitation, abuse and traf- fore be excluded from assistance. Women and children
ficking.16 Without support and protection networks, among these urban refugees and asylum seekers are at
they may have particular difficulty coping emotion- risk of harassment, exploitation, human trafficking and
ally. Similar predations may await children who are, gender-based violence.18 Refugee and asylum-seeking
or who move with, refugees or internally displaced children and adolescents, particularly those unaccom-
persons fleeing conflict or environmental distress. panied by adults, are especially vulnerable during the
resettlement phase.19 Children born to migrant parents
More than half the world’s registered refugees live in may end up stateless and unable to enjoy the rights of
urban areas.17 Some have official status, but many more citizenship. Internally displaced persons may find them-
selves without economic resources and may be seen as
competing with the urban poor for social services. For
© UNICEF/NYHQ2011-0015/Frederic Sautereau
Urban challenges 39
Economic shocks statistical evidence on youth unemployment tends to
The effects of the economic crisis unleashed in the be weak, partly because a significant proportion of
financial capitals of high-income countries in 2007 young people work outside the formal sector. There
continue to be felt around the world in high unem- are indications, however, that the crisis has swelled
ployment, deteriorating work conditions, dwindling the ranks of the ‘working poor’ – a category in which
real incomes, and food and fuel prices that are high young people are overrepresented26 – and slowed prog-
and difficult to predict. ress in poverty reduction, education and health care.27
Globally, there were 30 million more unemployed In extreme cases, persistent unemployment can contri-
people in late 2010 than before the crisis broke, and bute to civil unrest. Urban areas tend to be the focus of
the number continued to grow in 2011.22 The burden such turmoil, as the high concentrations of people make
is disproportionately borne by workers aged 15–24, it easier to reach critical mass. Potential or actual civil
whose unemployment rate rose from 11.8 per cent in disturbance is a concern in many cities of West Africa,
2007 to 12.6 per cent in 2010.23 Studies of previous where the movement of young people from rural areas
economic downturns suggest that this generation of to cities has reached extremely high levels28 and job
young people could end up detached and disillusioned, growth has been insufficient to absorb the influx.29
with long-term repercussions for their personal and
collective well-being.24 In North Africa and the Middle East, young people frus-
trated by a lack of economic opportunity accounted
Unemployment figures for urban youth are hard to for a significant proportion of demonstrators in the
obtain, but those that are available paint a worrying wave of protests that spread across the region in
picture. Young people in Sierra Leone’s urban areas the spring of 2011, following the self-immolation
are more likely to be unemployed than either rural of a young graduate in Tunisia in December 2010.
youth or urban adults.25 In low-income countries, the
© UNICEF/NYHQ2009-1449/Peter Wurzel
Residents of a neighbourhood in Manila, Philippines, contend with mud and stagnant water in the aftermath of floods caused by Tropical Storm Ketsana.
© UNICEF/NYHQ2010-1241/Cliff Volpe
better-educated, mostly urban, young people. The
supply of skilled jobs has simply not matched demand
for them. The opposite is true of the member coun-
tries of the Organisation for Economic Co-operation
and Development (OECD), where unemployment is
highest among the least educated.30
Since Graça Machel’s landmark Impact of Armed and Afghanistan and trafficking in rare minerals in the
Conflict on Children report was published in 1996, the Democratic Republic of the Congo. Urban gangs, most
international community has focused increasingly on this often composed of young men, can morph into militias, as
subject of grave concern. Millions of children have been was the case with the West Side Boys, who were tacti-
killed, injured, orphaned or separated from their fami- cally employed by combatants in Sierra Leone’s civil war
lies. Millions more have been deprived of schooling in of 1991–2002.
Iraq, Pakistan and other countries embroiled in armed
conflict. Often, the deprivation has been worst in cities. While armed conflict is not exclusive to urban areas, it is
In Tajikistan, for example, researchers have found that clear that an attack on a densely populated city neigh-
primary school enrolment rates remained lower in bourhood – whether by government forces, rebel militias
urban areas than in the countryside for years after or terrorists – maximizes casualties, including among chil-
the 1992–1998 conflict. dren. In some cases, civilians are deliberately targeted
in order to create a greater political impact – as with
Although armed conflict is distinct from the quotidian explosive devices detonated in busy urban areas such as
violence of gangs and organized criminal activity, the markets. In other cases, combatants claim that broader
two increasingly overlap. To secure resources, armed war aims justify the costs of civilian death or injury. All
groups may become involved with criminal trafficking assaults on civilians, however, and especially those on
networks, as is the case with the drug trade in Colombia children, are violations of international human rights law.
People all over the world hear stories, of violence and retaliation in our parks want to test you. If you fail those tests,
watch movies and see postcards of New and influencing every decision we make, you’re a target. Kids who don’t fit in get
York City. They recognize our skyline – the down to when and where we buy grocer- teased, harassed and even attacked. As
Empire State Building, the Statue of Liberty ies, so that we can have a better chance our 17-year-old peer Crystal told a United
or the Brooklyn Bridge – on sight. But New of avoiding confrontation. We’ve seen Nations panel in 2011, she was attacked
York City is not just about the big lights, the enough to know that once you’re in a by seven girls on her way to a bus stop
big buildings. There are the streets, and gang, you’re done. There is a good chance because she was wearing brand-name
then there are the people who walk them, that you’ll have to die to get back out. clothes popular at the school from which
and when you live here you learn that she had just moved, but shunned at her
New York is just like any city, filled with Young people feel a common pressure to new school.
people who struggle to make ends meet. gain respect and a sense of belonging,
but overcrowded living conditions and We’ve all had these kinds of experiences,
In the neighbourhoods where we are constant changes in our lives can make but we have learned how to handle them
growing up, we see the rougher side of accomplishing that impossible. Gangs and move forward.
this famous city. Poverty is part of life in give a kind of power and protection, and
our overcrowded and under-resourced this creates a lot of pressure to join. It’s Young people like us have a role to play.
communities. Peer pressure influences true that you can get respect for doing Even in difficult neighbourhoods there are
kids to drop out of school, and many end something you’re good at, but if you live the positive influences of strong fami-
up in jail or dead. The face of poverty might in an under-resourced neighbourhood the lies and inspiring people, and we have
change from one place to the next, but how opportunities and support you need to get the power to seek out those positive role
poverty is felt is the same. It connects us truly good at something don’t come so models and to become them ourselves.
with young people from other cities. often. The fact that people believe join- All of us want to be those people, and we
ing a gang is their best option shows how want a chance to change the communi-
We live in different parts of the city, but we deeply problems run here. ties we grew up in for the better. By living
have had the common experience of shar- through so many of the injustices associ-
ing in street libraries. These are outdoor Violence is serious in poor communi- ated with growing up in under-resourced
libraries, set up on blankets by volunteers ties; it creates a cycle that keeps people neighbourhoods, we’ve gained the knowl-
who bring books and arts to our neigh- in poverty. But extreme poverty is a form edge we need to start the process of
bourhoods. The libraries are places of of violence itself, because it forces chil- change, change that will create places
peace where young people and children dren and families to use so much of their where all families are treated with
can work together and support each other. energy to defend their rights against respect and dignity.
They are important because violence is a such threats as eviction and gentrifica-
major part of our lives. We have had to run tion, which cause rents to rise and force Speaking out about our lives is part of
away from family barbecues when shoot- poorer families to move frequently. As a how we can create that change. People
outs began, and we have teachers who result, many of us have had to move to can’t speak for us who have never lived
have stopped even trying to break up fights completely different neighbourhoods and the lives we describe. But when we get
in class because they’re so common. schools. These kinds of transitions are to speak on behalf of our own experi-
always scary and challenging, but in the ences and ourselves, that’s freedom of
Gangs are one of the worst problems city, they are common and can be down- speech, and that’s a positive step.
facing our communities. Gangs affect the right dangerous for us. When you’re new
entire neighbourhood, causing outbursts to a neighbourhood or school, people
This essay was contributed by Crystal Dantzler (aged 17), Najayah Foote (13), Tatyana Foote (13), Jammie Hatcher (11), Brianna Jeanniton (15), Jadora
Lindsey (18), Malcom Smith (14), Shakora Townsend (15) and the young people of All Together in Dignity (ATD) Fourth World Movement, New York City.
Urban challenges 43
© UNICEF/NYHQ2011-1402/Warrick Page
A boy pushes a cart in the flooded city of Hyderabad, Sindh Province, Pakistan.
The causes of violence affecting children in urban areas On average, children join gangs around age 13, but
are many and complex, but prominent among them evidence suggests a trend towards earlier enlistment.34
are poverty and inequality. The insufficient provision In marginal urban settings, gangs can offer children a
of public services and such community infrastruc- sense of identity, belonging and protection, as well as
ture as schools and recreational areas is common to financial reward. Children from poor backgrounds,
the cities of low-income countries and those in high- often growing up with few opportunities to escape
income countries whose governments are prone to unemployment, may see little prospect of securing their
social austerity. High rates of crime and violence often own future or supporting their families. They drop
prevail in such places. The experience of being deprived out of school, disillusioned with its lack of potential
of something to which one believes one is entitled trig- to improve their situation. In urban areas where the
gers a sense of exclusion and can lead to frustration state fails to provide such essentials as safe water, elec-
and violence. A study of 24 of the world’s 50 wealth- tricity or gas, health care, housing, education or legal
iest countries confirmed that more unequal societies protection, gangs sometimes step in to fill the vacuum.35
are more likely to experience problems associated with
this kind of relative deprivation: high rates of crime, While it is difficult to measure the impact of specific
violence and imprisonment.33 Incarceration is itself a institutional approaches to the challenge of reducing
problem because violence is common in prisons and violence, evidence suggests that community policing
detention centres. programmes – which include community participation
and special training for police personnel – have proved
In many parts of the world, urban gangs made up successful in urban areas of Brazil, Colombia, Costa
entirely or partly of young people are known for Rica and Guatemala.36
committing such crimes as extortion, petty theft,
selling or trafficking drugs, armed robbery, murder Successful strategies to prevent violence involve all
and carjacking. levels of the community and serve to establish trust
© UNICEF/NYHQ2011-0140/Graeme Williams
ity stemming from weather-related hazards.40 Even
conservative models predict more extreme weather –
heavier rainfall, stronger windstorms and more intense
heat waves – adding to the existing burden of disaster.41
Vulnerable locations and the great and generally in-
creasing concentrations of people and enterprises can
make cities especially dangerous. The proximity of
residential and industrial areas, the lack of space for
evacuation, poor drainage, the potential for the rapid
spread of communicable disease due to high population
density – all of these factors can intensify disaster risk.42
Urban challenges 45
PERSPECTIVE PACIFIC CHALLENGES
by Tuiloma Neroni Slade, Secretary General,
Pacific Islands Forum Secretariat
There are few places in the world where with certain areas reaching a density of for artistic expression, forging of new
population growth and urbanization collide 7,000 people per square kilometre. identities, better access to technology,
more starkly with vulnerability to climate wider social networks and new forms
change and disaster risk than in the While urbanization affects all members of of entertainment. At the same time, the
Pacific region. This confluence of issues our communities, it is clear that its mani- combination of elevated school dropout
is central to the focus of the Pacific Plan, fold social, environmental and economic rates, unemployment and the absence
the master strategy for regional devel- consequences significantly affect the of stabilizing traditional social support
opment endorsed by leaders of the lives of children and young people. A structures renders many young people
Pacific Islands Forum in 2005 to promote recent study conducted by the Pacific vulnerable to destructive influences.
economic growth, sustainable develop- Islands Forum Secretariat and the Pacific
ment, good governance and security. As Centre of the United Nations Development Proactively addressing the challenges
increasing numbers of Pacific Islanders Programme, Urban Youth in the Pacific: presented by urbanization will have a great
move to towns and cities, the region’s Increasing resilience and reducing risk for impact on the well-being of children and
long-standing tradition of rural ‘subsis- involvement in crime and violence, docu- young people – the major players in build-
tence affluence’ is being eroded, and mented a wide range of links between ing the future success of our communities
societies are grappling with new aspects urbanization and social problems, with a and ensuring the continued viability of
of urban poverty, including undernutri- particular focus on young people’s height- our environments. The situation demands
tion, youth unemployment and crime. ened exposure to crime and violence. a holistic and equitable approach, begin-
Another research study found that one ning with critical issues such as access to
Almost a quarter of Pacific Islanders live third of all children in Port Vila, Vanuatu, safe water, housing and schools. Disaster
in urban centres (up from only 8.5 per cent live in poverty – a rate nearly 20 per cent mitigation and preparedness strategies are
in 1950), and half of the countries in the higher than the national average. also of fundamental importance in densely
region already have majority urban popu- populated areas. At the same time, a
lations. While Vanuatu and Solomon Traditionally, the land and the sea have deeper understanding of the push and pull
Islands remain predominantly rural – provided generations with shelter and factors that result in the rural-urban drift
74 per cent and 81 per cent, respectively sustenance. The links between urban may enable us to develop sustainable,
– their urban growth rates are among the communities and the environment are targeted and practical policies to better
highest in the world. In Fiji, urban growth weaker. People are more dependent on harness the potential of our young people
has been compounded by the termination store-purchased commodities and, conse- in both the formal and informal sectors.
of land leases in some rural areas, which quently, are vulnerable to the vagaries of
pushed renters to seek employment and global economic fluctuations. The knock- Pacific leaders need to make a deter-
shelter in towns and cities. Migration, both on effects are felt as children are taken mined effort to tackle the challenges of
rural-urban and international, has resulted out of school, families cut back on food, urbanization, because unless we address
in the decline of stable populations in and financial worries lead to increased what is one of the most pressing forces
parts of Polynesia. Rapid urban growth is domestic violence and youth crime. of our time, the vision of the Pacific as a
particularly significant in the context of region of peace, harmony, security and
the geography of Pacific Island countries. Despite the disadvantages, the economic prosperity – where everyone
For example, the Tarawa atoll in archipe- possibilities offered by the urban envi- can lead free and worthwhile lives – will
lagic Kiribati includes some of the most ronment attract young people over any remain illusory. The future of the next
densely populated islands in the world, other group. These include opportunities generation is at stake.
Tuiloma Neroni Slade is the Secretary General of the Pacific Islands Forum Secretariat. He was formerly a judge at the International Criminal Court in
The Hague, Netherlands; Ambassador/Permanent Representative of Samoa to the United Nations in New York and, concurrently, Ambassador to the
United States; as well as High Commissioner to Canada. Justice Slade has also served as Attorney-General of Samoa and as senior legal adviser of
the Commonwealth Secretariat in London.
© UNICEF/NYHQ2010-0764/Roger LeMoyne
When disaster strikes, supportive environments criti-
cal to children’s well-being may break down. Families
may remain in emergency camps for extended periods,
and these dysfunctional environments can become the
only home children know during their formative years.
Urban challenges 47
CHAPTER
© UNICEF/NYHQ2011-0549/Olivier Asselin
Towards cities
fit for children
Many cities have pursued initiatives to improve technical assistance to community-based workers and
children’s well-being. This chapter outlines some exam- prepares contingency measures to protect children and
ples of good practice spanning service delivery, social their families in crisis situations.1
protection and safe and inclusive urban environments.
These cases illustrate the myriad possibilities and bene- Collaboration between authorities and child rights
fits of including children and their interests in urban agencies can facilitate such efforts. In 1999, the
design and management. Brazilian state of Ceara teamed up with UNICEF to
launch the Municipal Seal of Approval, an initiative
that encourages mayors to promote child well-being
Policy and collaboration through local cultural, political and administrative
National policies – particularly decentralization – channels. By recognizing and rewarding success, the
can enable municipalities to deliver for children. For programme provides municipal authorities with strong
instance, in 1991, the Philippines enacted the Local incentives to prioritize the well-being of children and
Government Code, granting fiscal and administrative young people in their jurisdictions. The initiative
autonomy and planning authority to local government has now spread to over a thousand municipalities
units. This opened the door for a number of localities across Brazil and has been taken up by other coun-
– notably Pasay City, a subdivision of Metropolitan tries in the region; mayors from El Salvador signed up
Manila – to pursue pro-child urban governance. In in 2009. Within Brazil, it became the inspiration for
addition to creating plans and evaluating projects, the the Platform for Urban Centres, which aims to reduce
Pasay City Child Welfare Council, the regulatory body disparities that affect children and adolescents living
responsible for all initiatives for children, promotes in large cities.
child-friendly regulations and budgets, provides
Urban growth adds to the challenges Of course, an environment conducive Our municipality also recognizes the
of ensuring that people can enjoy an to child well-being cannot be created educational and social benefits of sports
adequate standard of living. through sporadic, isolated actions. – especially their contribution to building
We need a comprehensive, concerted decision-making skills, respect for diver-
In Sobral, a municipality in the northwest approach to policymaking as well as inte- sity and confidence among young people.
of the state of Ceara and home to more gral service delivery. Our achievements in Our Social Nucleus of Sports Initiation
than 188,000 people, serious efforts have improving the lives of children and youth programme allows children and adoles-
been made to include an expanding have earned us the UNICEF Municipal cents to practice sports by making existing
population in the labour market, schools, Seal of Approval every time it has been sports facilities in all districts of the city
housing and all the social and economic issued: in 2000, 2002, 2004, 2006 and 2008. available and accessible to them. We also
aspects of daily life. partner with child rights advocates and a
Sobral is pursuing a series of intercon- local business to promote the participation
Almost 70,000 people – just over a third of nected initiatives to enable all its chil- of marginalized youth in cultural workshops
Sobral’s population – are not yet 19. With dren, regardless of background, to and training programmes. Many of these
the right policies and services, we can have access to appropriate tools to young people are adolescents who are
play a part in creating an environment in fully develop their capacities. We have excluded because they have experienced
which they can thrive and build healthy, steadily focused on enhancing education, drug addiction, pregnancy or sexual abuse.
fulfilling lives. chiefly by renovating school facili-
ties and providing continuous coaching Beyond the numbers and formal initia-
Although enabling children to realize their to teachers – efforts rewarded by tives, individual stories tell us that our
rights is part of our mandate, success improved results in national tests. We efforts help adolescents make positive
can also bring long-term rewards. Today’s are working to extend access to other decisions to the benefit of their communi-
beneficiaries are likely to become tomor- forms of training, for example through ties. I remember one young man who, at a
row’s benefactors, contributing to a planned partnership with the Palace recent project impact assessment meet-
stronger, more cohesive communities. of Sciences and Foreign Languages to ing, said that many of his friends had been
deliver language and information tech- lost to drugs and crime. He had found the
So much needs to be done. An increasing nology programmes. This would build on motivation to succeed despite the odds.
population puts existing resources under successful initiatives already in place. Having entered the School Workshop
strain. Poverty and inequality create a The School of Music offers compli vocational training programme at 16, he
sense of helplessness and frustration, mentary courses in a variety of musical was now, 10 years later, working as an
which in turn often leads to crime and instruments to nearly 650 students, instructor in historical restoration.
violence – daily realities in urban centres largely from public schools. The School
across the region – complicating the Workshop of Arts and Professions I am one of countless mayors facing
already complex process of fostering provides training in such professional similar challenges and opportunities. We
an environment where children can grow. skills as preserving the city’s historical all have our own insights and experiences.
It is difficult not to notice the factors heritage. In addition, more than 10,000 of But some motivations are universal – the
that make young people especially our students participate in after-school satisfaction of seeing children on the brink
susceptible to violence: poor quality of sports and tutorial classes under Second turn their lives around and become role
life, limited opportunities for development Round, a federal government project. models for others. This is why I believe in
and recreation, and an absence of the unique role of local government – in
viable prospects. Sobral and around the world.
José Clodoveu de Arruda Coelho Neto is a lawyer and professor. Politically active since his youth, he served as vice-mayor of Sobral from 2005 to 2010
and became mayor in January 2011.
Urban HEART
Measuring and responding to health inequity
The spectrum of urban living conditions existing interventions and are effective • Community participation: involving
is reflected in the health of a city’s resi- and sustainable over time. community members in all aspects of the
dents. Despite the wide disparities in process, from planning, designing and
health outcomes that stem from differ- The tool is based on three essential implementing interventions to helping
ential circumstances, few countries elements: ensure that these efforts are learned from
routinely examine such inequities within and sustained beyond the initial phase.
or between cities. • Sound evidence: reliable, representative
and comparable data, disaggregated by Urban HEART revolves around a planning
The Urban Health Equity Assessment sex, age, socio-economic status, major and implementation cycle compris-
and Response Tool (Urban HEART) helps geographical or administrative region, ing four phases: assessment, response,
urban policymakers, communities and and ethnicity, as appropriate policy and programme. Monitoring and
other stakeholders better understand the evaluation take place during each phase.
local socio-economic factors that influ- • Intersectoral action for health: building
ence health outcomes. Developed by relationships beyond the health sector Urban health inequities are identified in
the World Health Organization (WHO), in order to influence a broad range of the assessment phase. Evidence gath-
Urban HEART is designed to tackle urban health determinants – in particular, ered at this stage forms the basis for
health inequities – avoidable differences working with other government sectors raising awareness, determining solutions
in health that are socially produced (e.g., education, transport and public and promoting action.
rather than biologically determined. The works), community groups and non-
tool serves to identify and correct poli- governmental organizations
cies that perpetuate these inequities – for
instance, the higher rates of illness and
death among the children of families in Figure 4.1. Urban HEART planning and implementation cycle
urban poverty than among those born
into relatively affluent homes.
Urban HEART provides local and national Defining the Setting the
authorities with the evidence they need problem agenda
to set priorities, allocate resources and
mobilize urban communities to promote
health equity. To determine which inter- Assessment Response
ventions are likely to improve health and
reduce inequities, this evidence seeks to Monitoring
URBAN HEART
show not just the immediate causes of and evaluation
disease but also the ‘causes of causes’
Programme Policy
– underlying social hierarchies and the
resulting conditions in which people
grow, live, work and age.
Implementing Developing
the programme policy
Reducing health and social inequities
is complex. Implementation of Urban
HEART focuses on local solutions that
engage all stakeholders, consider
Source: WHO Urban HEART.
52 STATE OF
THE STATE OF THE
THEWORLD’S
WORLD’SCHILDREN
CHILDREN2012
2012
The response stage involves identify- Monitoring and evaluation encompass each indicator be further disaggregated
ing appropriate responses, designating both process and outcomes. by location, sex, age and/or socio-
key actors, defining goals and estab- economic group.
lishing targets. This is an opportunity to Core indicators
engage all relevant sectors and commu- Indicators measuring selected health Embedding Urban HEART
nities in setting the agenda – determining outcomes and social determinants for Urban HEART is primarily a tool to
which policies, programmes and proj- different urban population groups form enhance current interventions as part of
ects should be introduced, continued, the basis of the assessment compo- existing national and local health plan-
expanded, improved, changed or stopped nent of Urban HEART. Indicators fall into ning and programme frameworks. The
to achieve equity goals. two main categories: health outcomes chosen health equity solutions should
(shown in blue in Figure 4.2) and social be results-focused, cost-effective and
During the policy stage, the most determinants of health (shown in grey). timely; use available local resources
relevant interventions are prioritized Twelve core indicators are used across where possible; ensure broad support
and budgeted to ensure that they become all Urban HEART schemes, allowing among affected communities; and comply
part of the local government policy- comparison across cities and countries. with national priorities. Intervention
making process. Success is measured This basic set was selected to provide strategies include incorporating health
by the laws, programmes and interven- a general picture of the urban health in urban planning and development,
tions implemented. situation in any urban setting, based on strengthening the role of urban primary
generally available data, universality health care and promoting an emphasis
Programme implementation hinges on and potential to uncover inequity. The on health equity.
resources and time frames determined by 12 ‘core’ indicators are complemented by
local authorities. Health sector programmes ‘strongly recommended’ and ‘optional’
implementing pro-equity health policies are ones to provide an analysis responsive
complemented by other sectors’ actions to local priorities and specific health
to bring about health equity. equity concerns. It is recommended that
Completion of Government
Infant mortality Access to safe water Unemployment
primary education spending on health
Fully immunized
Tuberculosis
children
WHO Urban HEART was developed by the WHO Centre for Health Development in Kobe, Japan (WHO Kobe Centre), in collaboration with regional offices
of WHO and city and national officials from across the world. In total, 16 municipalities and 1 state in 10 countries – Brazil, Indonesia, Iran (Islamic
Republic of), Kenya, Malaysia, Mexico, Mongolia, the Philippines, Sri Lanka and Viet Nam – participated in the pilot scheme.
There are an estimated 2.5 million people In my homeland of Puerto Rico, I collabo- Effective anti-trafficking laws must be
worldwide who have been trafficked into rated with the University of Puerto Rico passed in conjunction with work done
forced labour. Some 22 to 50 per cent and the Protection Project at Johns by local protection offices. In order to
of trafficking victims are children. The Hopkins University on the first study of do this, we urgently need governments,
precise magnitude of the problem is diffi- trafficking in the territory. Among other non-governmental organizations and
cult to ascertain because definitions vary things, we learned that although the multilateral agencies to work in concert
and trafficking is a clandestine business. United States passed the Trafficking to raise awareness, implement holistic
We do know that children are usually Victims Protection Act in 2000, there are training and guidance programmes for
trafficked from rural to urban areas and no comprehensive local laws to combat enforcement agencies and build effective
that the forms of exploitation to which this crime in Puerto Rico. systems to protect children and prose-
they are subjected – domestic servitude, cute and punish perpetrators.
sexual exploitation linked to tourism, and The testimonies we collected were heart-
drug running, to name a few – are most breaking but ultimately enabled us to Finally, it is our responsibility to support
common in highly populated places and recommend ways to end this noxious survivors of trafficking. We must endeav-
on the streets. threat to our children and communities. our to create a safe environment that
One consequence of these recommen- allows survivors to come forward
For the most part, trafficking is denied dations will be the construction of a safe despite the inherent difficulties. Policies
or ignored – even if, by some estimates, haven for children and young people must be revised to exempt identified
it is a global industry with US$32 billion in the coastal town of Loiza, where the victims of trafficking from persecution
in annual profits from forced labour. incidence of trafficking is high. or deportation, and assistance must
Trafficked children toil behind the walls be provided to help their reintegration,
of private homes, hotel rooms and sweat- To effectively address this scourge, we including tracing families where appro-
shops – obscure places from which most must begin by establishing a universal priate. Some of these actions have
never come forward for fear of prosecu- definition of trafficking. Child traffick- already been initiated at the state and
tion or, for those who were taken across ing must be distinguished from human international levels.
borders, deportation. smuggling and the activities of orga-
nized crime. Doing so will help generate It is easy to forget the silent and invisible
I was moved to join the fight against more specific data on which to base poli- – especially when they are lost among
trafficking when I visited India in 2002. cies designed to protect children. Better the masses in congested cities. For this
In 2006 I launched Llama y Vive (Call information will also help ensure that reason, we must reinforce and develop
and Live), a campaign that established people in general, and policymakers in effective solutions to put child trafficking
and promoted prevention and victim- particular, see all aspects of the prob- at the top of the agenda. Taking action
protection hotlines. A first for the region lem – a key to mobilizing political support now can help address the root causes
when it was launched, the campaign for adequate anti-trafficking legislation of trafficking, safeguarding children and
has taken root in Costa Rica, Ecuador, and enforcement. defending their right to protection and
Mexico, Nicaragua and Peru as well social development.
as in in the Hispanic community of
Washington, D.C.
Multiple Grammy winner, renowned international artist and UNICEF Goodwill Ambassador since 2003, Ricky Martin established the Ricky Martin
Foundation to advocate for the well-being of children around the globe.
Cities Initiative
Fifteen years of trailblazing work
With nearly half of the world’s children While these are necessary components In the Philippines, the Child-Friendly
now living in towns and cities, urban of child-friendly programming and Movement has established an accredi-
planners and policymakers need to pay advocacy, true ‘child-friendliness’ can tation mechanism for urban communities
special attention to the rights and inter- only be achieved through a long-term and municipalities, measuring improve-
ests of children. The Child-Friendly commitment to the implementation of ments in 24 priority indicators of child
Cities Initiative (CFCI) – launched by child rights. well-being in the fields of protection,
UNICEF and the United Nations Human health, nutrition, education, water and
Settlements Programme (UN-Habitat) in The Child-Friendly Cities approach can sanitation, and participation.
1996 – is the first multi-stakeholder part- be adapted to diverse contexts. In high-
nership to put children at the centre of income countries, the focus has been In the absence of a formal evaluation
the urban agenda. largely on urban planning, safe and mechanism, the benefits of CFCI can be
green environments and child participa- demonstrated by example. In 2005, local
City administrations have had to face tion. Low-income countries have tended authorities in Brazil that had earned the
significant challenges in addressing the to prioritize service delivery in health, Municipal Seal of Approval were found
needs of a growing urban population. nutrition, education and child protection. to have cut infant mortality by 16.4 per
Coinciding with increasing decentraliza- Child-Friendly Cities initiatives range from cent (against 12.1 per cent elsewhere)
tion and as part of efforts to strengthen single-city endeavours (as in Amman, and neonatal mortality by 8.5 per cent
governance, CFCI taps into the wider Jordan) to national-level networks (as in (against 1.6 per cent), while increasing
acceptance of community participa- France). The potential to promote child- access to early childhood education
tion in decision-making to promote local centred governance at the local level is from 56 per 100 children to 63.5 per 100.
accountability for children’s rights. leading to the spread of child-friendly
approaches beyond large cities and even Underpinning child-friendly urban
The International Secretariat of CFCI to rural settings, for instance in Morocco planning and programming is a human
has identified nine principal building and the Sudan. rights-based governance model that
blocks for local administrations aiming to embodies the principles of non-
become ‘child-friendly’: Integrated, multi-level approaches are discrimination, survival and develop-
an important feature of the Child-Friendly ment, and participation enshrined in the
1. Child participation at all stages of Cities movement. In Brazil, the Platforms Convention on the Rights of the Child.
planning and implementation for Urban Centres promote synergy Children are recognized as rights holders
2. Child-friendly legislation among municipal and state authorities who should be involved in both plan-
3. A child rights strategy and other stakeholders in order to reduce ning and implementation of measures
4. A coordinating mechanism or agency socio-economic inequalities affecting that affect them. By making neglected
for children children in the biggest cities. Children groups more visible and granting all chil-
5. Assessment of policy and and other community members assess dren a platform to secure their needs and
programme impact on children children’s living conditions and develop rights, the Child-Friendly Cities approach
6. A budget and resources for children a plan of action that includes perfor- contributes to achieving development
7. A regular report on the state of mance indicators for communities goals with equity.
children in the city and municipalities.
8. Awareness-raising and capacity
building on child rights
9. Independent advocacy for children.
A peer educator discusses how to prevent HIV/AIDS and other sexually transmitted diseases in Barangay Don Carlos, a poor neighbourhood in
Pasay City, Metropolitan Manila, Philippines.
Farming within and on the fringes of urban areas – on In the neighbourhood of San Juan de Lurigancho in
abandoned plots, community allotments or roofs, or metropolitan Lima, Peru, the Stronger Voices for
in sacks and containers, for example – is an increas- Reproductive Health project focuses on improving the
ingly important means of enhancing food security and quality and accessibility of reproductive health services
generating income. Around half the food consumed for adolescent girls and other young people, many of
in Hanoi, Viet Nam, in 2001 was grown in the city.6 them indigenous migrants, by consulting them on how
Additional benefits accrue as the presence of trees and best to deliver these services.9
crop plants enhances urban air quality and contributes
to a healthier, greener environment for children.7
HIV and AIDS
Engaging young people is an essential ingredient of
Health successful efforts to prevent HIV. Take the case of
The Global Equity Gauge Alliance is an international Shuga, a television drama set and produced in Nairobi,
initiative designed to target urban health inequities. Kenya. The show uses a plot revolving around young
For example, in Cape Town, South Africa, communi- urban Kenyans to explore such themes as alcohol
ties and health workers were involved at every stage abuse, risky sexual behaviour, stigma and HIV. An
of the project, which entailed reallocating health assessment of viewers – adolescents and young people
staff, running health promotion programmes in – found that quality popular media can be a success-
schools and piloting the introduction of dry toilets in ful channel through which to transmit knowledge and
informal settlements.8 promote safer practices.10
Girls attending the Urban Out of School Programme in Biratnagar, Nepal. The programme offers working and underprivileged children an
opportunity to catch up on their education.
grown to include over 2,000 members – more than half helps them secure employment. Trainees are recruited
of whom are girls – across the whole city. The clubs via posters, roadshows and social media. The project,
raise awareness of child rights; campaign on important run by Plan International, was developed by the CAP
issues, such as exploitative labour, child marriage and Foundation, a public-private partnership aiming to
trafficking; and advocate for more child participation in alleviate poverty by linking the learning and livelihood
schools, in the community and in governance – includ- needs of working children and disadvantaged youth. It
ing by working with municipal authorities to make was first tried successfully in India.13
Biratnagar a child-friendly city. Many of those who have
gone on to pursue college education or professional Following the influx of Iraqi refugees into Syria – more
careers return to the club to mentor their younger peers. than 200,000 people, according to 2009 data, the
majority settling in Damascus – the Syrian Government
Mobile libraries are an effective way of making sure opened the doors of its public schools to Iraqi children.
that all children have access to books. In Manila, Allowances were made for late registration and cross-
Philippines, for example, library carts deliver books to border examinations. Among the obstacles encountered
working children.12 were the absence of school records, children’s need
to work to contribute to their family’s income, and
The Forsa (Opportunity) programme based in El differences between the Iraqi and Syrian curricula. A
Marg, a large slum community outside Cairo, Egypt, number of innovative approaches were pursued. One
provides three months’ training to young people and involved ‘education volunteers’ – selected professionals
© UNICEF/NYHQ2004-0707/Giacomo Pirozzi
Safe cities for girls
Sexual harassment and violence are a daily reality
for girls and women in urban public spaces, and one
that has been largely neglected. The risk and reality of
violence limit women’s freedom to exercise their rights,
as equal citizens, to education, work, recreation and
political expression. Those living in poverty may be
exposed to heightened risk if they walk through inse-
cure areas to reach school or work. It is increasingly
recognized that cities that are safe for women and girls
are safe for all, yet municipal development and safety
A group session at a centre for children and adolescents in Kaliningrad,
plans frequently overlook specific threats to women Russian Federation. The facility offers counselling on drugs, alcohol,
and girls. HIV/AIDS, abuse and other issues.
Upgrading informal
settlements in JeddaH
Informal settlements pose a complex One of the biggest obstacles to include physical changes to buildings
question: how best to formalize their developing slum infrastructure is the lack and the public realm to improve struc-
unofficial existence, legalize makeshift of formal land ownership. In Jeddah, tural soundness and comfort, or the
homes and provide them with appropri- the authorities are addressing this chal- provision of social infrastructure (such as
ate infrastructure and services? Often, lenge through the Jeddah without Slums schools and clinics) and utilities (water,
such settlements have simply been relo- programme. Since 2007, this effort has energy and sewerage). In each case,
cated. But UN-Habitat, recognizing that been overseen by a public-private part- care is taken to minimize the disruption
socio-economic networks have taken nership, the Jeddah Development and caused by the construction process.
root in these areas, identifies partici- Urban Regeneration Company (JDURC),
patory slum upgrading as one of the formed specifically to facilitate legaliza- Each plan contains interchangeable
preferred strategies for achieving cities tion of land titles, improvement of local options that involve greater or lesser
without slums. This kind of slum upgrad- environments and increased provision of degrees of change to the physical
ing is an extremely complicated task and services for residents. fabric. This allows the upgrading plan to
is truly participatory and effective only respond to different levels and combi-
when it incorporates the needs of chil- In their joint work, the Municipality nations of official, private-sector and
dren – because communities that work of Jeddah, JDURC and Space Syntax community commitments of financial and
for their youngest members tend to work have sought to address a wide range political capital. Higher levels of fund-
for everyone. Space Syntax Limited, an of conditions by combining scientific ing allow a more complete upgrading
urban planning and design consultancy measurement, spatial analysis and of buildings, public realms, social infra-
affiliated with University College London, physical intervention with community structure and utilities. Lower levels mean
has developed an evidence-based, partic- engagement and cultural considerations. the focus will be less on individual build-
ipatory approach to upgrading informal Each settlement is studied, using the ings and more on shared public services
settlements in Jeddah, Saudi Arabia. urban planning technique of spatial (see Figure 4.3). During all stages of
layout analysis, to understand how its development, consultations are held with
Jeddah’s 50-plus unplanned settlements problems are related to the streets, paths local residents, municipalities, traditional
occupy around 16 per cent of the city’s and other routes that knit it together representatives, developers and JDURC
area and house more than 1 million and link it to the wider city. Many infor- to ensure that stakeholders are engaged
people – one third of its population. mal settlements are poorly connected. and included in the upgrading process.
Inhabitants often lack sanitation, proper This complicates residents’ attempts to
shelter and secure tenure, and they also make use of opportunities in other parts Child rights, unfortunately, are not always
experience inequality in the allocation of of the city and can lead to or reinforce at the forefront of urban planning and
social services and amenities. Despite economic exclusion, social segregation – as inclusive as these stakeholder
the challenges, these neighbourhoods do and stigmatization. Overcoming these consultations seek to be – more needs to
provide opportunities to prosper. Many problems involves the creation of new be done to listen to children’s voices. The
residents are migrants who join the exist- physical connections and the redesign perception seems to be that conditions
ing communities by setting up small of existing ones. adequate for adults are sufficient for all.
businesses or working in the service However, it is important not to treat chil-
industries that support the local and An upgrading plan is developed for each dren as a homogeneous group. Girls and
regional economies. neighbourhood based on its unique situ- boys of different ages use urban space
ation and needs. These needs might in diverse ways, respond to it differently
Figure 4.3. Design scenarios for an informal settlement, showing the scale of change from maximum
(high-level funding) to minimum (low-level funding) intervention
High-level
funding
Mid-level
funding
Jeddah’s
informal
settlements
Low-level
funding
© UNICEF/NYHQ2006-2457/Giacomo Pirozzi
Uniting for
children in an
urban world
This edition of The State of the World’s Children has of eviction or on the street, where they are at risk of
sought to shed light on the experience of children and violence and exploitation. Moreover, they are denied
young people in urban areas, especially the poorest their right to take part in decisions affecting them.
and most marginalized. It has covered issues as diverse Instead, they are excluded from the process of finding
as sanitation, gangs and governance. And it has taken the solutions that could improve their lives and those
in the broad sweep of global trends and focused in on of countless others.
individual, concrete examples of positive practices in
specific urban neighbourhoods. Throughout, it has Mainstream approaches to development often view all
been concerned about disparity and the harm it does children in urban areas as a homogeneous group and
to the youngest members of the human family. use statistical aggregates to determine resource allo-
cation and programming actions. An equity-focused
Hundreds of millions of children and young people live approach is needed to direct solutions precisely to
in the same cities as political, cultural and commercial those children who are hardest to reach. It is time to
elites – yet they struggle to subsist. Too many spend do things differently: to live up to the commitments
their days picking through rubbish for something to of the Millennium agenda by ensuring that marginal-
sell or making bricks for other people’s homes. They ized children in urban centres receive greater attention
spend their nights in makeshift dwellings under threat and investment.
© UNICEF/NYHQ2006-1768/Michael Kamber
an urban area is needed if the particular problems
faced by children in urban areas are to be identified
correctly. Existing definitions vary greatly, complicating
comparative analysis.
© UNICEF/NYHQ2011-0956/Marta Ramoneda
A 14-year-old girl stands on the balcony of a hostel in Benghazi, Libya. Following armed conflict that also displaced her family in 2011, the city’s schools
were closed and adolescent girls had few recreational opportunities.
Promoting knowledge and use of available services and their communities, the police, town planners
among target populations is also vital. Since 2002, for and policymakers in fighting gender-based violence.
example, the Global Equity Gauge Alliance has chal- Promising national initiatives are also under way, nota-
lenged urban health inequities through outreach and bly in Latin America. In Guatemala, for example, the
community engagement in a number of countries. In CEIBA programme aims to provide young people with
Cape Town, South Africa, for example, residents and an alternative to drugs and a way out of violence by
health workers are involved at every stage of the proj- training them in job skills that are in local demand.
ect, which entails reallocating health staff, running
health promotion programmes in schools and provid- Safe public transport and well-regulated traffic are
ing dry toilets in informal settlements.4 vital components of a city fit for children. Road acci-
dents kill more of the world’s young people than any
The agenda must encompass not only services but other single cause. Successful initiatives in Colombia,
also protection. Violence, in all its forms, is a common Sweden and the Netherlands have combined car-free
denominator in the poorest and most marginalized areas, dedicated bicycle and pedestrian routes, and
neighbourhoods. It is increasingly and accurately public transport to reduce injuries and deaths.
viewed by the international community as a major
threat to the rights and well-being of all, especially Ensuring that all children are registered and docu-
children and women. Efforts are being made to tackle mented must be a top priority because, however ardent
violence as an international issue, as evidenced by the efforts to promote equity, it likely will elude chil-
Safe and Friendly Cities for All, a joint initiative of dren who lack official documents. About a third of all
UN-Habitat, UN-Women and UNICEF that aims to children in urban areas go unregistered at birth, and
develop municipal prevention strategies with a strong that proportion is closer to 50 percent in sub-Saharan
focus on participation. Through such measures as Africa and South Asia.5
legislation and policy, training, mass media campaigns,
activism and budget review, it engages women, children
One of the more promising developments women form collectives to pool savings people living ‘illegally’ on pavements, under
in the effort to reduce urban poverty is and make loans to one another so they bridges and on waste land. These residents
the emergence of networks of grassroots can put food on the table, buy medicines, are not counted in the census; they are
groups in which women play a prominent get transport to find jobs and pay for chil- excluded from voting lists; and their chil-
role as agents of positive change in their dren’s education. In time, they examine dren’s births are not recorded. But when
communities and around the world. their environs and identify what they need. their presence is documented through
settlement profiles and family identifica-
We have had the privilege of working At the top of the list of needs is security tion papers, it becomes clear that they
with one such network – Shack/Slum of tenure. Children need a decent place are gainfully employed, contribute to the
Dwellers International (SDI) – since to live, places to play and neighbour- city’s economy and are worthy of citizen-
its inception in 1996. There are similar hoods in which they feel safe. They need ship. Because such documentation also
networks of street vendors, home-based clean water and toilet solutions that do identifies the children in each household,
workers and waste pickers. not force two-year-olds to stand in line it becomes possible to determine how
or expose adolescent girls to harass- many need immunization and schooling,
We believe that unless we band together, ment. Security of tenure makes it easier how many work and what kind of work
the challenges of urban poverty will not to fulfil these needs. It also frees children they do. In addition to being our basic
be addressed. By joining forces and from the stress and lost opportunities organizing tool, this process of enumer-
pooling our knowledge, experience and that come with the ever-present threat ation enables negotiation for tenure and
creative solutions, we can achieve action of being forcibly evicted or having their service provision. The process yields
on a meaningful scale. So it is that slum homes demolished. Insecurity of tenure another benefit for children – seeing
dwellers in such cities as Nairobi, Kenya, means that women and children must parents, especially their mothers, nego-
and Kampala, Uganda, are consult- work near their dwellings so they are tiate collectively to improve lives and
ing counterparts in Mumbai, India, who close at hand in case of eviction. Children surroundings is a vital part of children’s
persuaded government, railway author- serve as ‘road runners’, warning parents socialization.
ities and international development and neighbours when a demolition squad
lenders to relocate some 20,000 house- has been sighted; as their homes are Clearly, these networks cannot solve
holds as part of an effort to update the destroyed, they scramble to protect the problems of all children. But they
rail system. Ultimately, the Mumbai slum whatever they can from being taken by are important allies in the endeavour to
residents were able to design their own the police. Living in constant fear of evic- safeguard child rights, and they under-
resettlement, moving from locations where tion erodes whatever resources a family take critical foundational work to make
many children had been killed by trains has. But when secure tenure is negoti- children’s homes and neighbourhoods
passing a mere 9 metres from homes. ated, children start going to school, and safe and secure. They can bridge the
parents feel more confident about invest- gap between the formal urban develop-
SDI has hundreds of thousands of ing in proper shelter. ment world and poor urban communities,
federated members in cities spread promoting solutions that work for their
across 34 countries. They work for decent Here, too, the experience of grassroots members. We know from our work that
housing and infrastructure, usually seek- networks is instructive. An essential poor communities are fed up with others
ing to collaborate with local government. element of SDI’s work is making what setting development priorities for them.
This takes years of organizing, mobilizing was invisible hard to ignore. Cities often True alliances and partnerships mean
and building relationships. It begins when have no data recording the presence of making choices together.
Sheela Patel chairs the board of SDI. She works with the Indian non-governmental organizations Mahila Milan, the National Slum Dwellers Federation and
the Society for the Promotion of Area Resource Centres (SPARC), which was established in 1984 to address issues faced by the pavement dwellers of
Mumbai. Celine d’Cruz is the coordinator of SDI. A founder of SPARC, she began working for the rights of pavement and slum dwellers in India in the early
1980s, helping impoverished women in Mumbai bargain collectively to bring housing, education and health services to their families.
72 STATE OF
THE STATE OF THE
THEWORLD’S
WORLD’SCHILDREN
CHILDREN2012
2012
Clearly, urban governance needs strengthening so that
© UNICEF/NYHQ2005-1199/Roger LeMoyne
it is more capable of delivering policies and services
that benefit and safeguard the rights of children. Too
many city governments pander to vested interests and
are too readily prepared to accept the status quo, which
often involves vast, unplanned informal settlements
that fail to meet people’s needs. There is a manifest
need to enhance accountability.
The voice and involvement of children and adolescents Where municipal authorities do not have sufficient
can be an important aspect of this partnership but, all capacity, community-based organizations and NGOs
too frequently, child participation becomes a matter of can also play a part. Examples include Kilikili, an
tokenism. Examples from around the world show the organization in Bangalore, India, that creates green
many benefits, for both children and policymakers, of play spaces and involves children, including those with
encouraging representation at the municipal level. In special needs, in the design process.
four South American cities, a multi-stage, long-term
process of urban consultation with local governments There is more at stake here than ‘child’s play’. Public
has led to safer and more equitable cities. Positive play spaces can help mitigate overcrowding and lack
outcomes include improvements to public infrastruc- of privacy in the home and enable children to mix with
ture in Rio de Janeiro and Sao Paulo, Brazil; higher peers of different ages and backgrounds. This early
literacy rates in Cotacachi, Ecuador; and expanded experience of diversity can add to the foundations of
birth registration in Ciudad Guayana, Bolivarian a more equitable society.9 Moreover, a large body of
Republic of Venezuela. evidence shows that exposure to trees, water and the
natural landscape benefits children’s physical, mental
The international Child-Friendly Cities Initiative has and social well-being.10
succeeded in putting child rights on the urban agenda.
To be awarded child-friendly status, a city must show
that it fosters child participation and pursues child Work together to achieve
rights through its strategy, legislation, budgeting, results for children
impact assessments and public awareness programmes. The projects and programmes discussed in this report
The scheme has great potential for expansion, offer only a glimpse of what is being done to ensure
particularly in rapidly growing, rapidly urbanizing equitable access to services and protection. Taken
middle-income countries. together, they provide a sense of what can happen
when children’s rights are placed at the centre of the
Children and adolescents should be encouraged to urban agenda in active partnership with communities.
become involved in projects to improve their cities.
Their participation gives them an empowering chance Under any circumstances, but especially in these strait-
to air their views and engages them in understanding ened times, actors at all levels – from the local to the
urban development and respecting their environment. global – and from civil society as well as the public
Successful projects, such as Map Kibera in Nairobi, and private sectors need to pool their resources and
Kenya, have shown how adolescents can assist in gener- energies to create urban environments conducive to
ating an effective base of knowledge for development children’s rights.
A boy reads in his bed in Kuleana, a centre for boys who work on the streets, in the city of Mwanza, United Republic of Tanzania.
Non-governmental organizations and international and national political and economic realities, influence
agencies can play a crucial part in fostering the cultural norms and attitudes, and re-establish trust
engagement of children in municipal governance and among authorities, institutions and the general public.
community decision-making. Local communities and
authorities must engage each other if children’s rights Civil society organizations, and particularly commu-
are to be realized. In addition, such cross-border nity-based organizations, should be embraced in urban
issues as migration and trafficking demand urgent programming and governance, as they play a critical
coordinated action. part in enabling local communities to influence policy.
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Overview . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 82
General note on the data. . . . . . . . . . . . . . . . . . . . . . . . . . . . . 82
Child mortality estimates . . . . . . . . . . . . . . . . . . . . . . . . . . . . 82
Revisions to statistical tables . . . . . . . . . . . . . . . . . . . . . . . . . 84
Explanation of symbols . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 86
Under-five mortality rankings. . . . . . . . . . . . . . . . . . . . . . . . . 87
Regional Classification. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 124
Measuring human development:
An introduction to Table 10. . . . . . . . . . . . . . . . . . . . . . . . 125
TABLES
1 Basic indicators. . . . . . . . . . . . . . . . . . . . . . . . . . 88
2 Nutrition. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 92
3 Health. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 96
4 HIV/AIDS. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 100
5 Education. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 104
6 Demographic indicators. . . . . . . . . . . . . . . . . . 108
7 Economic indicators . . . . . . . . . . . . . . . . . . . . . 112
8 Women. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 116
9 Child protection. . . . . . . . . . . . . . . . . . . . . . . . . 120
10 The rate of progress . . . . . . . . . . . . . . . . . . . . . 125
11 Adolescents. . . . . . . . . . . . . . . . . . . . . . . . . . . . 130
12 Equity – Residence . . . . . . . . . . . . . . . . . . . . . . 134
13 Equity – Household wealth . . . . . . . . . . . . . . . 138
Statistical tables 81
Statistical tables
Overview
This reference guide presents the most recent key statistics on child survival, development and protection for the
world’s countries, territories and regions in a single volume. Last year, for the first time, The State of the World’s
Children 2011 included tables on Adolescents and Equity, the latter focusing on disparities by household wealth. The
State of the World’s Children 2012 adds a second table on Equity, focusing on urban-rural disparities.
The statistical tables presented in this volume help meet the demand for timely, reliable, comparable and
comprehensive data on the state of the world’s children. They also support UNICEF’s focus on progress and
results towards internationally agreed goals and compacts relating to children’s rights and development. UNICEF
is the lead agency responsible for global monitoring of the child-related goals of the Millennium Declaration as
well as the Millennium Development Goals (MDGs) and indicators; the organization is also a key partner in the
United Nations’ work on monitoring these targets and indicators.
The numbers presented in this reference guide are available online at <www.unicef.org/publications> and
<www.unicef.org/sowc2012>, and via the UNICEF global statistical databases at <www.childinfo.org>.
Please refer to these websites for the latest tables and for any updates or corrigenda subsequent to printing.
Multiple Indicator Cluster Surveys (MICS): UNICEF Regional Classification: In the 2009 edition of The State
supports countries in collecting statistically sound of the World’s Children, UNICEF added two new regional
and internationally comparable data through MICS. groupings: Africa and Asia. In addition, the number of
Since 1995, nearly 230 surveys have been conducted countries classified in the sub-Saharan Africa region
in approximately 100 countries and territories. The increased with the inclusion of Djibouti and the Sudan.
fourth round of MICS, involving over 50 countries, is As a result, regional estimates for sub-Saharan Africa
under way, with data collection expected to end in published in previous issues of The State of the World’s
2011. MICS are among the largest sources of data for Children may not be comparable with those published
monitoring progress towards internationally agreed in this issue. For details of the countries and territories
development goals for children, including the MDGs. included in all UNICEF regions, please refer to the
Many of the MICS indicators have been incorporated Regional Classification, page 124.
into the statistical tables in this report. More informa-
tion is available at <www.childinfo.org>.
Statistical tables 83
Statistical tables
Statistical tables 85
Statistical tables
boys, as it takes into account all children participating complete country and regional estimates for the years
at a given level, regardless of age. 1990, 1995, 2000, 2005 and 2008, as well as details on
the methodology, can be found at <www.childinfo.org/
Survival rate to the last grade of primary: females as maternal_mortality.html>.
a % of males: This highlights progression through
school and is an official indicator for MDG 2. For Table 9. Child protection
the first time in The State of the World’s Children, Violent discipline: Previous estimates used in UNICEF
this indicator is being presented as ‘females as a publications and in MICS country reports prior to 2010
% of males’, which adds a dimension of gender were calculated using household weights that did not
disaggregation not included in previous editions. take into account the last-stage selection of children
for the administration of the child discipline module in
Maternal mortality ratio (adjusted): The table presents MICS surveys. (A random selection of one child aged
the ‘adjusted’ maternal mortality ratios for the 2–14 is undertaken for the administration of the child
year 2008, as produced by the Maternal Mortality discipline module.) In January 2010, it was decided
Estimation Inter-agency Group (MMEIG), composed that more accurate estimates are produced by using
of WHO, UNICEF, the United Nations Population Fund a household weight that takes the last-stage selection
(UNFPA) and the World Bank, together with indepen- into account. MICS 3 data were recalculated using this
dent technical experts. To derive these estimates, the approach. All UNICEF publications produced after 2010,
inter-agency group used a dual approach: making including The State of the World’s Children 2012, use
adjustments to correct misclassification and under- the revised estimates.
reporting in existing estimates of maternal mortality
from civil registration systems, and using a model Table 11. Adolescents
to generate estimates for countries without reliable Lower and upper secondary gross enrolment ratios:
national-level estimates of maternal mortality. Introduced for the first time, these indicators aid the
understanding of adolescent participation in second-
These ‘adjusted’ estimates should not be compared ary school. Disaggregating the secondary level makes
to previous inter-agency estimates, as the method- the issue of dropout more evident.
ological approach is not the same. A full report with
Explanation of symbols
Because the aim of these statistical tables is to provide a broad picture of the situation of children and women
worldwide, detailed data qualifications and footnotes are seen as more appropriate for inclusion elsewhere.
Sources and years for specific data points are available at <www.childinfo.org>.
Symbols specific to a particular table are included in the table footnotes. The following symbols are
common across all tables:
– Data are not available.
x Data refer to years or periods other than those specified in the column heading. Such data are not
included in the calculation of regional and global averages.
y Data differ from the standard definition or refer to only part of a country. Such data are included in the
calculation of regional and global averages.
* Data refer to the most recent year available during the period specified in the column heading.
** Excludes China.
# For a complete list of countries and territories in the regions, subregions and country categories,
see page 124.
1
Because of the cession in July 2011 of the Republic of South Sudan by the Republic of the Sudan, and its subsequent admission to the
United Nations on 14 July 2011, disaggregated data for the Sudan and South Sudan as separate States are not yet available for most indicators.
Aggregated data presented are for the Sudan pre-cession.
Statistical tables 87
TABLE 1: BASIC INDICATORS
Annual no. Life Primary
Neonatal Total Annual no. of under-5 GNI per expectancy Total adult school net % share of
Under-5 Under-5 Infant mortality mortality population of births deaths capita at birth literacy enrolment household income
mortality mortality rate rate (under 1) rate (thousands) (thousands) (thousands) (US$) (years) rate (%) ratio (%) 2000–2010*
Countries and territories rank 1990 2010 1990 2010 2010 2010 2010 2010 2010 2010 2005–2010* 2007–2009* lowest 40% highest 20%
Afghanistan 11 209 149 140 103 45 31,412 1,385 191 330 x 48 – – 22 39
Albania 108 41 18 36 16 9 3,204 41 1 4,000 77 96 85 20 43
Algeria 69 68 36 55 31 18 35,468 714 26 4,460 73 73 95 18 x 42 x
Andorra 172 9 4 7 3 1 85 1 0 41,130 x – – 84 – –
Angola 8 243 161 144 98 41 19,082 795 121 3,960 51 70 – 8 62
Antigua and Barbuda 145 26 8 23 7 4 89 2 0 10,610 – 99 90 – –
Argentina 126 27 14 24 12 7 40,412 694 10 8,450 76 98 – 13 51
Armenia 98 55 20 46 18 11 3,092 47 3,090 74 100 93 22 40
Australia 165 9 5 8 4 3 22,268 303 1 43,740 x 82 – 97 18 x 41 x
Austria 172 9 4 8 4 2 8,394 74 0 46,710 81 – – 22 38
Azerbaijan 63 93 46 74 39 19 9,188 182 9 5,180 71 100 86 20 42
Bahamas 118 22 16 18 14 7 343 5 0 d 75 – 92 – –
Bahrain 139 17 10 15 9 4 1,262 23 0 25,420 x 75 91 99 – –
Bangladesh 61 143 48 99 38 27 148,692 3,038 140 640 69 56 89 22 41
Barbados 98 18 20 16 17 10 273 3 0 d 77 – – – –
Belarus 156 17 6 14 4 3 9,595 106 1 6,030 70 100 95 23 36
Belgium 172 10 4 9 4 2 10,712 122 1 45,420 80 – 99 21 41
Belize 113 44 17 35 14 8 312 8 0 3,740 76 – 100 11 x 59 x
Benin 20 178 115 107 73 32 8,850 350 39 750 56 42 94 18 46
Bhutan 52 139 56 96 44 26 726 15 1 1,920 67 53 88 14 53
Bolivia
(Plurinational State of) 55 121 54 84 42 23 9,930 263 14 1,790 66 91 95 9 61
Bosnia and Herzegovina 145 19 8 17 8 5 3,760 32 0 4,790 76 98 87 18 43
Botswana 61 59 48 46 36 19 2,007 47 2 6,890 53 84 87 9x 65 x
Brazil 103 59 19 50 17 12 194,946 3,023 55 9,390 73 90 95 11 58
Brunei Darussalam 152 12 7 9 6 4 399 8 0 31,180 x 78 95 97 – –
Bulgaria 130 22 13 18 11 7 7,494 76 1 6,240 73 98 98 14 51
Burkina Faso 3 205 176 103 93 38 16,469 713 120 550 55 29 64 18 47
Burundi 14 183 142 110 88 42 8,383 283 38 160 50 67 99 21 43
Cambodia 58 121 51 87 43 22 14,138 318 16 760 63 78 89 16 52
Cameroon 15 137 136 85 84 34 19,599 710 93 1,160 51 71 92 15 51
Canada 156 8 6 7 5 4 34,017 383 2 41,950 x 81 – – 20 40
Cape Verde 69 59 36 46 29 14 496 10 0 3,160 74 85 83 13 56
Central African Republic 9 165 159 110 106 42 4,401 154 23 460 48 55 67 15 49
Chad 5 207 173 113 99 41 11,227 503 80 600 49 34 – 17 47
Chile 142 19 9 16 8 5 17,114 245 2 9,940 79 99 95 24 31
China 108 48 18 38 16 11 1,341,335 16,486 315 4,260 73 94 96 z 16 48
Colombia 103 37 19 30 17 12 46,295 914 18 5,510 73 93 93 8 62
Comoros 34 125 86 88 63 32 735 28 2 820 61 74 87 8 68
Congo 29 116 93 74 61 29 4,043 142 13 2,310 57 – – 13 53
Cook Islands 142 20 9 17 8 5 20 0 0 – – – 98 – –
Costa Rica 139 17 10 15 9 6 4,659 73 1 6,580 79 96 – 12 55
Côte d'Ivoire 18 151 123 105 86 41 19,738 673 80 1,070 55 55 57 16 48
Croatia 156 13 6 11 5 3 4,403 43 0 13,760 76 99 95 20 42
Cuba 156 13 6 11 5 3 11,258 112 1 5,550 x 79 100 100 – –
Cyprus 172 11 4 10 3 2 1,104 13 0 30,460 x 79 98 99 – –
Czech Republic 172 14 4 12 3 2 10,493 115 0 17,870 78 – – 25 x 36 x
Democratic People's
Republic of Korea 73 45 33 23 26 18 24,346 348 12 a 69 100 – – –
Democratic Republic
of the Congo 6 181 170 117 112 46 65,966 2,873 465 180 48 67 – 15 51
Denmark 172 9 4 7 3 2 5,550 64 0 58,980 79 – 95 23 x 36 x
Djibouti 31 123 91 95 73 34 889 26 2 1,280 x 58 – 45 17 47
Dominica 133 17 12 14 11 8 68 1 0 4,960 – – 98 – –
Dominican Republic 81 62 27 48 22 15 9,927 216 6 4,860 73 88 82 13 54
Ecuador 98 52 20 41 18 10 14,465 299 6 4,510 75 84 97 13 54
Egypt 91 94 22 68 19 9 81,121 1,881 41 2,340 73 66 95 22 42
El Salvador 118 62 16 48 14 6 6,193 126 2 3,360 72 84 96 13 52
Equatorial Guinea 19 190 121 118 81 35 700 26 3 14,680 51 93 57 – –
Eritrea 49 141 61 87 42 18 5,254 191 11 340 61 67 37 – –
Estonia 165 21 5 17 4 3 1,341 16 0 14,360 75 100 97 18 43
Ethiopia 23 184 106 111 68 35 82,950 2,613 271 380 59 30 84 23 39
Fiji 113 30 17 25 15 8 861 19 0 3,610 69 – 92 – –
Statistical tables 89
TABLE 1:
3: BASIC
HEALTHINDICATORS
Annual no. Life Primary
Neonatal Total Annual no. of under-5 GNI per expectancy Total adult school net % share of
Under-5 Under-5 Infant mortality mortality population of births deaths capita at birth literacy enrolment household income
mortality mortality rate rate (under 1) rate (thousands) (thousands) (thousands) (US$) (years) rate (%) ratio (%) 2000–2010*
Countries and territories rank 1990 2010 1990 2010 2010 2010 2010 2010 2010 2010 2005–2010* 2007–2009* lowest 40% highest 20%
Nepal 59 141 50 97 41 28 29,959 724 35 490 68 59 – 15 54
Netherlands 172 8 4 7 4 3 16,613 183 1 49,720 81 – 99 21 x 39 x
New Zealand 156 11 6 9 5 3 4,368 64 0 29,050 x 81 – 99 18 x 44 x
Nicaragua 81 68 27 52 23 12 5,788 138 4 1,080 74 78 93 12 57
Niger 12 311 143 132 73 32 15,512 755 100 360 54 29 54 20 43
Nigeria 12 213 143 126 88 40 158,423 6,332 861 1,180 51 61 63 15 49
Niue 91 14 22 12 19 10 1 0 0 – – – – – –
Norway 186 9 3 7 3 2 4,883 60 0 85,380 81 – 99 24 37
Occupied Palestinian Territory 91 45 22 36 20 – 4,039 134 3 b 73 95 78 – –
Oman 142 47 9 36 8 5 2,782 50 1 17,890 x 73 87 81 – –
Pakistan 33 124 87 96 70 41 173,593 4,741 423 1,050 65 56 66 21 42
Palau 103 33 19 27 15 9 20 0 0 6,460 – – – – –
Panama 98 33 20 26 17 9 3,517 70 1 6,990 76 94 97 11 57
Papua New Guinea 49 90 61 65 47 23 6,858 207 12 1,300 62 60 – 12 x 56 x
Paraguay 87 50 25 40 21 14 6,455 156 4 2,940 72 95 86 11 57
Peru 103 78 19 55 15 9 29,077 594 11 4,710 74 90 97 12 53
Philippines 80 59 29 42 23 14 93,261 2,344 66 2,050 68 95 92 15 50
Poland 156 17 6 15 5 4 38,277 405 3 12,420 76 100 96 20 42
Portugal 172 15 4 11 3 2 10,676 99 0 21,860 79 95 99 17 x 46 x
Qatar 145 21 8 17 7 4 1,759 21 0 d 78 95 98 – 52
Republic of Korea 165 8 5 6 4 2 48,184 478 3 19,890 81 – 99 21 x 38 x
Republic of Moldova 103 37 19 30 16 9 3,573 44 1 1,810 69 98 90 18 45
Romania 126 37 14 29 11 8 21,486 221 3 7,840 74 98 96 21 39
Russian Federation 133 27 12 22 9 6 142,958 1,682 20 9,910 69 100 94 16 49
Rwanda 31 163 91 99 59 29 10,624 438 38 540 55 71 96 12 58
Saint Kitts and Nevis 145 28 8 22 7 5 52 1 0 9,980 – – 94 – –
Saint Lucia 118 23 16 18 14 10 174 3 0 4,970 74 – 93 15 x 49 x
Saint Vincent and
the Grenadines 97 27 21 21 19 13 109 2 0 4,850 72 – 98 – –
Samoa 98 27 20 23 17 8 183 5 0 2,930 72 99 99 – –
San Marino 193 12 2 11 2 1 32 0 0 50,670 x – – 92 – –
Sao Tome and Principe 37 94 80 61 53 25 165 5 0 1,200 64 89 98 14 56
Saudi Arabia 108 45 18 36 15 10 27,448 595 12 17,200 x 74 86 86 – –
Senegal 42 139 75 70 50 27 12,434 465 34 1,050 59 50 75 17 46
Serbia 152 29 7 25 6 4 9,856 111 1 5,820 74 98 96 23 37
Seychelles 126 17 14 14 12 8 87 3 0 9,490 – 92 94 27 29
Sierra Leone 4 276 174 162 114 45 5,868 226 39 340 47 41 – 16 49
Singapore 186 8 3 6 2 1 5,086 45 0 40,920 81 95 – 14 x 49 x
Slovakia 145 18 8 15 7 4 5,462 57 0 16,220 75 – – 24 x 35 x
Slovenia 186 10 3 9 2 2 2,030 20 0 23,860 79 100 98 21 39
Solomon Islands 81 45 27 36 23 12 538 17 0 1,030 67 – 81 – –
Somalia 1 180 180 108 108 52 9,331 408 70 a 51 – – – –
South Africa 51 60 57 47 41 18 50,133 1,059 58 6,100 52 89 90 9 63
South Sudanδ – – – – – – – – – – – – – – –
Spain 165 11 5 9 4 3 46,077 498 2 31,650 81 98 100 19 42
Sri Lanka 113 32 17 26 14 10 20,860 378 6 2,290 75 91 95 17 48
Sudanδ – – – – – – – – – – – – – – –
Suriname 78 52 31 44 27 14 525 10 0 5,920 x 70 95 90 11 x 57 x
Swaziland 39 96 78 70 55 21 1,186 35 3 2,600 48 87 83 12 56
Sweden 186 7 3 6 2 2 9,380 112 0 49,930 81 – 96 23 37
Switzerland 165 8 5 7 4 3 7,664 76 0 70,350 82 – 100 20 41
Syrian Arab Republic 118 38 16 31 14 9 20,411 465 8 2,640 76 84 – 19 44
Tajikistan 46 116 63 91 52 25 6,879 192 12 780 67 100 98 23 39
Thailand 130 32 13 26 11 8 69,122 838 11 4,210 74 94 90 11 59
The former Yugoslav
Republic of Macedonia 133 39 12 34 10 8 2,061 22 0 4,520 75 97 93 15 50
Timor-Leste 54 169 55 127 46 24 1,124 44 2 2,220 62 51 83 21 41
Togo 24 147 103 87 66 32 6,028 193 19 440 57 57 95 16 47
Tonga 118 25 16 21 13 8 104 3 0 3,380 72 99 – – –
Trinidad and Tobago 81 37 27 32 24 18 1,341 20 1 15,380 70 99 96 16 x 46 x
Tunisia 118 49 16 39 14 9 10,481 179 3 4,070 74 78 99 16 47
Turkey 108 80 18 66 14 10 72,752 1,298 24 9,500 74 91 95 16 46
Turkmenistan 52 98 56 78 47 23 5,042 109 6 3,700 65 100 – 16 x 47 x
SUMMARY INDICATORS#
Africa 160 111 99 71 33 1,020,650 35,631 3,804 1,483 57 63 78 16 49
Sub-Saharan Africa 174 121 105 76 35 855,273 32,087 3,709 1,192 54 62 76 16 49
Eastern and Southern Africa 156 98 97 63 30 398,968 14,191 1,322 1,486 55 67 87 16 50
West and Central Africa 196 143 115 88 39 411,864 16,442 2,241 905 53 57 66 16 48
Middle East and
North Africa 77 41 56 31 18 417,879 9,955 415 2,752 71 75 88 19 44
Asia 86 48 62 37 24 3,649,320 66,076 3,186 2,913 69 80 93 18 46
South Asia 120 67 86 52 33 1,630,173 37,452 2,492 1,241 65 61 91 20 45
East Asia and Pacific 55 24 41 19 13 2,019,147 28,624 694 4,286 72 94 95 16 48
Latin America and Caribbean 54 23 43 18 11 584,676 10,845 249 7,859 74 91 95 12 56
CEE/CIS 50 23 41 19 11 404,582 5,820 136 7,263 70 98 94 18 45
Industrialized countries 10 6 9 5 3 989,508 11,425 65 40,845 80 99 96 18 43
Developing countries 97 63 67 44 25 5,621,340 120,617 7,516 3,304 68 80 89 17 48
Least developed countries 170 110 106 71 34 832,330 27,996 2,949 669 59 58 80 18 46
World 88 57 61 40 23 6,856,797 134,754 7,614 8,796 70 84 90 17 47
# For a complete list of countries and territories in the regions, subregions and country categories, see page 124.
δ Because of the cession in July 2011 of the Republic of South Sudan by the Republic of the Sudan, and its subsequent admission to the United Nations on 14 July 2011, disaggregated data for the Sudan and South Sudan as separate States are
not yet available for most indicators. Aggregated data presented are for the Sudan pre-cession (see Memorandum item).
Statistical tables 91
TABLE 2: NUTRITION
Vitamin A
% of children (2006–2010*) who are: % of under-fives (2006–2010*) suffering from: supplementation % of
% of infants Early initiation introduced to underweight wasting stunting coverage rate households
with low of breastfeeding exclusively solid, semi-solid breastfed (WHO) (WHO) (WHO) (6–59 months) consuming
birthweight (%) breastfed or soft foods at age 2 moderate moderate moderate 2010 iodized salt
Countries and territories (2006–2010*) (2006–2010*) (<6 months) (6–8 months) (20–23 months) & severe severe & severe & severe full coverageΔ (%) (2006–2010*)
Afghanistan – – – 29 x 54 x 33 x 12 x 9x 59 x 96 28 x
Albania 7x 43 39 54 y 31 5 2 9 19 – 76
Algeria 6 50 7 39 y 22 3 1 4 15 – 61
Andorra – – – – – – – – – – –
Angola – 55 11 x 77 x 37 x 16 y 7y 8y 29 y 28 45
Antigua and Barbuda 5 – – – – – – – – – –
Argentina 7 – – – 28 2y 0y 1y 8y – –
Armenia 7 28 x 35 48 y 23 5 1 4 19 – 97 x
Australia – – – – – – – – – – –
Austria 7x – – – – – – – – – –
Azerbaijan 10 32 12 44 y 16 8 2 7 25 89 w 54
Bahamas 11 – – – – – – – – – –
Bahrain – – – – – – – – – – –
Bangladesh 22 43 43 74 y 91 41 12 17 43 100 84 y
Barbados 12 – – – – – – – – – –
Belarus 4x 21 x 9x 38 x 4x 1x 1x 2x 4x – 94 y
Belgium – – – – – – – – – – –
Belize 14 51 10 – 27 4 1 2 22 – –
Benin 15 32 – 76 y 92 18 5 8 43 100 67
Bhutan 10 59 49 67 66 13 3 6 34 – 96 x
Bolivia (Plurinational State of) 6 61 60 79 y 40 4 1 1 27 24 89 y
Bosnia and Herzegovina 5 57 x 18 x 29 x 10 x 1x 0x 4x 10 x – 62 x
Botswana 13 20 20 46 y 6 11 4 7 31 91 –
Brazil 8 43 40 70 y 25 2 – 2 7 – 96 y
Brunei Darussalam – – – – – – – – – – –
Bulgaria 9 – – – – – – – – – 100
Burkina Faso 16 20 16 – – 26 7 11 35 100 34
Burundi 11 x – 69 70 y 79 29 8 6 58 73 98 x
Cambodia 9 65 74 82 y 43 28 7 11 40 – 83 y
Cameroon 11 20 21 64 y 21 16 5 7 36 89 49 y
Canada – – – – – – – – – – –
Cape Verde 6x 73 x 60 x 80 x 13 x – – – – – 75
Central African Republic 13 39 23 55 y 47 24 8 12 43 0 62
Chad 22 x 34 x 3 36 59 30 13 16 39 68 56 x
Chile 6 – – – – – – – – – –
China 3 41 28 43 y – 4y – 3y 10 y – 97
Colombia 6x 57 43 70 y 33 3 1 1 13 – –
Comoros – – – – – – – – – 18 –
Congo 13 x 39 x 19 x 78 x 21 x 11 x 3x 8x 30 x 84 82 x
Cook Islands – – – – – – – – – – –
Costa Rica 7 – 15 – 49 1 – 1 6 – –
Côte d'Ivoire 17 25 4 54 y 37 16 5 8 40 100 84 x
Croatia 5x – – – – – – – – – –
Cuba 5 70 26 47 y 16 – – – – – 88 x
Cyprus – – – – – – – – – – –
Czech Republic 7x – – – – – – – – – –
Democratic People's
Republic of Korea 6 18 65 x 31 x 37 x 19 4 5 32 99 25 y
Democratic Republic
of the Congo 10 43 37 52 53 24 8 9 43 83 59
Denmark 5x – – – – – – – – – –
Djibouti 10 67 1 23 y 18 23 y 5y 10 y 31 y 95 0
Dominica 10 – – – – – – – – – –
Dominican Republic 11 74 9 62 y 21 7 2 3 18 – 19
Ecuador 8 – 40 x 77 x 23 x 6x – – – – –
Egypt 13 56 53 66 y 35 6 1 7 29 – 79
El Salvador 7x 33 31 72 y 54 6y 1y 1y 19 y – 62 x
Equatorial Guinea – – – – – – – – – 0 –
Eritrea 14 x 78 x 52 x 43 x 62 x 35 x 13 x 15 x 44 x 44 68 x
Estonia 4x – – – – – – – – – –
Ethiopia 20 x 69 x 49 x 54 x 88 x 33 x 11 x 12 x 51 x 84 20 x
Fiji 10 x 57 x 40 x – – – – – – – –
Statistical tables 93
TABLE 2: NUTRITION
Vitamin A
% of children (2006–2010*) who are: % of under-fives (2006–2010*) suffering from: supplementation % of
% of infants Early initiation introduced to underweight wasting stunting coverage rate households
with low of breastfeeding exclusively solid, semi-solid breastfed (WHO) (WHO) (WHO) (6–59 months) consuming
birthweight (%) breastfed or soft foods at age 2 moderate moderate moderate 2010 iodized salt
Countries and territories (2006–2010*) (2006–2010*) (<6 months) (6–8 months) (20–23 months) & severe severe & severe & severe full coverageΔ (%) (2006–2010*)
Nauru 27 76 67 65 y 65 5 1 1 24 – –
Nepal 21 35 53 75 y 95 39 11 13 49 91 –
Netherlands – – – – – – – – – – –
New Zealand – – – – – – – – – – –
Nicaragua 9 54 31 76 y 43 6 1 1 22 7 97 x
Niger 27 42 27 65 y – 40 y 14 y 16 y 47 y 98 32
Nigeria 12 38 13 75 y 32 23 9 14 41 91 97 x
Niue – – – – – – – – – – –
Norway – – – – – – – – – – –
Occupied Palestinian Territory 7 – 27 – – – – – – – 86
Oman 12 – – – – 9 – 7 10 – –
Pakistan 32 29 37 36 y 55 31 x 13 x 14 x 42 x 87 17 x
Palau – – – – – – – – – – –
Panama 10 x – – – – 4y – 1y 19 y – –
Papua New Guinea 10 x – 56 76 y 72 18 x 5x 5x 43 x 14 92
Paraguay 6 47 24 67 y 14 3x – 1x 18 x – 94 y
Peru 8 51 68 80 y 61 y 4 1 1 24 – 91 x
Philippines 21 54 34 58 y 34 22 y – 7y 32 y – 45 x
Poland 6x – – – – – – – – – –
Portugal 8x – – – – – – – – – –
Qatar – – – – – – – – – – –
Republic of Korea – – – – – – – – – – –
Republic of Moldova 6x 65 x 46 x 18 x 2x 3x 1x 5x 10 x – 60 x
Romania 8x – 16 x 41 x – 4x 1x 4x 13 x – 74 x
Russian Federation 6 – – – – – – – – – 35 x
Rwanda 6x 68 85 62 y 84 11 2 3 44 92 88 x
Saint Kitts and Nevis 8 – – – – – – – – – –
Saint Lucia 11 – – – – – – – – – –
Saint Vincent and
the Grenadines 8 – – – – – – – – – –
Samoa 10 88 51 71 y 74 – – – – – –
San Marino – – – – – – – – – – –
Sao Tome and Principe 8 45 51 73 y 20 13 3 11 29 41 86
Saudi Arabia – – – – – – – – – – –
Senegal 19 x 23 x 34 x 61 x 42 x 14 x 4x 9x 19 x – 41 x
Serbia 6 17 x 15 x 39 x 8x 1x 0x 4x 7x – 32
Seychelles – – – – – – – – – – –
Sierra Leone 14 51 11 73 y 50 21 7 10 36 100 58
Singapore – – – – – – – – – – –
Slovakia 7x – – – – – – – – – –
Slovenia – – – – – – – – – – –
Solomon Islands 13 75 74 81 y 67 12 2 4 33 – –
Somalia – 26 9 15 y 35 32 12 13 42 – 1
South Africa – 61 x 8x 49 x 31 x 9 – 5 24 – –
South Sudanδ – – – – – – – – – – –
Spain – – – – – – – – – – –
Sri Lanka 17 80 76 87 y 84 21 4 15 17 85 92 y
Sudanδ – – – – – – – – – – –
Suriname – 34 2 34 y 15 7 1 5 11 – –
Swaziland 9 44 44 – 11 6 1 1 31 38 52
Sweden – – – – – – – – – – –
Switzerland – – – – – – – – – – –
Syrian Arab Republic 10 46 43 – 25 10 – 12 28 33 w 79 x
Tajikistan 10 x 57 y 25 x 15 x 34 x 15 6 7 39 95 62
Thailand 7 50 15 – – 7 1 5 16 – 47
The former Yugoslav
Republic of Macedonia 6x – – – – 2 0 3 11 – 94 x
Timor-Leste 12 x 82 52 78 y 33 45 15 19 58 48 60
Togo 11 53 63 44 64 17 4 5 30 100 32
Tonga 3x – – – – – – – – – –
Trinidad and Tobago 19 41 13 43 y 22 – – – – – 28
Tunisia 5 87 6 61 y 15 3 – 3 9 – –
SUMMARY INDICATORS#
Africa 13 46 34 68 44 19 6 9 38 86 55
Sub-Saharan Africa 13 45 33 69 46 20 7 9 39 86 53
Eastern and Southern Africa – 54 49 81 54 15 4 6 39 80 65
West and Central Africa 13 39 24 63 42 23 8 11 40 90 –
Middle East and North Africa 11 45 34 57 31 11 4 9 28 – 48
Asia 18 42 38 55 69 ** 27 13 ** 13 34 56 ** 74
South Asia 27 39 45 56 76 42 15 19 47 50 55
East Asia and Pacific 6 45 29 54 44 ** 10 5 ** 6 19 84 ** 88
Latin America and Caribbean 8 42 42 71 33 4 – 2 15 – –
CEE/CIS 7 49 30 55 22 – – – – – –
Industrialized countries – – – – – – – – – – –
Developing countries 15 43 37 60 56 ** 18 θ 9 ** 10 29 θ 66 ** 71
Least developed countries 16 47 42 68 61 25 8 10 41 88 61
World 15 43 37 60 55 ** 16 θ 9 ** 10 27 θ 66 ** 71
# For a complete list of countries and territories in the regions, subregions and country categories, see page 124.
δ Because of the cession in July 2011 of the Republic of South Sudan by the Republic of the Sudan, and its subsequent admission to the United Nations on 14 July 2011, disaggregated data for the Sudan and South Sudan as separate States are
not yet available for most indicators. Aggregated data presented are for the Sudan pre-cession (see Memorandum item).
Statistical tables 95
TABLE 3: HEALTH
% under- % under-
fives with fives with Malaria 2006–2010*
Immunization 2010
suspected % under- diarrhoea
% of population % of population % of routine pneumonia fives with receiving %
using improved using improved EPI vaccines 1-year-old children immunized against: taken to an suspected oral rehy- % of % under-fives
drinking water sanitation financed by % appropriate pneumonia dration and house- under- with fever
sources facilities government TB DPT Polio Measles HepB Hib newborns health care receiving continued holds fives receiving
2008 2008 2010 corresponding vaccines: protected provider antibiotics feeding with at sleeping anti-
against least one under malarial
Countries and territories total urban rural total urban rural total BCG DPT1β DPT3β polio3 measles HepB3 Hib3 tetanusλ 2006–2010* 2006–2010* ITN ITNs drugs
Afghanistan 48 78 39 37 60 30 2 68 86 66 66 62 66 66 79 – – – – – –
Albania 97 96 98 98 98 98 100 99 99 99 99 99 99 99 87 70 60 63 – – –
Algeria 83 85 79 95 98 88 100 99 99 95 95 95 95 95 90 53 59 24 – – –
Andorra 100 100 100 100 100 100 100 – 99 99 99 99 96 98 – – – – – – –
Angola 50 60 38 57 86 18 29 93 97 91 92 93 91 91 75 – – – 28 18 29
Antigua and Barbuda – 95 – – 98 – – – 99 98 99 98 98 98 – – – – – – –
Argentina 97 98 80 90 91 77 100 99 98 94 96 99 94 94 – – – – – – –
Armenia 96 98 93 90 95 80 66 95 98 94 96 97 94 48 – 57 – – – – –
Australia 100 100 100 100 100 100 – – 97 92 92 94 92 92 – – – – – – –
Austria 100 100 100 100 100 100 – – 93 83 83 76 83 83 – – – – – – –
Azerbaijan 80 88 71 81 85 77 – 81 80 72 78 67 49 – – – – 31 – 1x 1x
Bahamas – 98 – 100 100 100 100 – 99 99 97 94 98 98 90 – – – – – –
Bahrain – 100 – – 100 – 100 – 99 99 99 99 99 99 94 – – – – – –
Bangladesh 80 85 78 53 56 52 29 94 98 95 95 94 95 95 93 37 – 68 – – –
Barbados 100 100 100 100 100 100 100 – 95 86 90 85 86 86 – – – – – – –
Belarus 100 100 99 93 91 97 – 99 99 98 99 99 96 0 – 90 x 67 x 54 x – – –
Belgium 100 100 100 100 100 100 – – 99 99 99 94 97 97 – – – – – – –
Belize 99 99 100 90 93 86 100 98 99 96 96 98 96 96 88 71 44 26 – – –
Benin 75 84 69 12 24 4 18 97 94 83 83 69 83 83 92 36 – 42 25 20 54
Bhutan 92 99 88 65 87 54 5 96 94 91 92 95 91 – 89 74 49 62 – – –
Bolivia (Plurinational State of) 86 96 67 25 34 9 – 90 87 80 80 79 80 80 74 51 64 29 – – –
Bosnia and Herzegovina 99 100 98 95 99 92 – 97 95 90 90 93 90 80 – 91 73 53 – – –
Botswana 95 99 90 60 74 39 100 99 98 96 96 94 93 – 92 14 x – 7x – – –
Brazil 97 99 84 80 87 37 100 99 99 98 99 99 96 99 92 50 – – – – –
Brunei Darussalam – – – – – – – 95 98 95 99 94 96 95 95 – – – – – –
Bulgaria 100 100 100 100 100 100 – 98 96 94 96 97 95 91 – – – – – – –
Burkina Faso 76 95 72 11 33 6 33 99 98 95 94 94 95 95 85 39 15 42 23 10 48
Burundi 72 83 71 46 49 46 9 93 99 96 94 92 96 96 94 38 x 26 x 23 x 52 45 17
Cambodia 61 81 56 29 67 18 40 94 93 92 92 93 92 92 91 64 – – 5x 4x 0x
Cameroon 74 92 51 47 56 35 96 96 92 84 83 79 84 84 91 35 38 22 4 13 58
Canada 100 100 99 100 100 99 – – 92 80 80 93 17 80 – – – – – – –
Cape Verde 84 85 82 54 65 38 – 99 99 99 99 96 98 – 92 – – – – – –
Central African Republic 67 92 51 34 43 28 – 74 64 54 47 62 54 54 86 32 39 47 16 15 57
Chad 50 67 44 9 23 4 65 52 71 59 63 46 59 59 60 26 31 23 42 10 36
Chile 96 99 75 96 98 83 – 95 93 92 92 93 92 92 – – – – – – –
China 89 98 82 55 58 52 – 99 99 99 99 99 99 – – – – – – – –
Colombia 92 99 73 74 81 55 100 84 96 88 88 88 88 88 79 64 – 52 3x – –
Comoros 95 91 97 36 50 30 – 76 81 74 82 72 81 81 85 56 x – 31 x – 9x 63 x
Congo 71 95 34 30 31 29 – 95 90 90 90 76 90 90 83 48 x – 39 x 8x 6x 48 x
Cook Islands – 98 – 100 100 100 90 99 99 99 99 99 99 99 – – – – – – –
Costa Rica 97 100 91 95 95 96 100 77 96 88 93 83 89 90 – – – – – – –
Côte d'Ivoire 80 93 68 23 36 11 55 91 95 85 81 70 85 85 82 35 19 45 10 3 36
Croatia 99 100 97 99 99 98 – 99 98 96 96 95 97 96 – – – – – – –
Cuba 94 96 89 91 94 81 99 99 98 96 99 99 96 96 – – – – – – –
Cyprus 100 100 100 100 100 100 21 – 99 99 99 87 96 96 – – – – – – –
Czech Republic 100 100 100 98 99 97 – – 99 99 99 98 99 99 – – – – – – –
Democratic People's
Republic of Korea 100 100 100 – – – 21 98 94 93 99 99 93 – 91 80 88 67 – – –
Democratic Republic of the Congo 46 80 28 23 23 23 0 85 67 63 72 68 63 63 77 40 42 37 49 36 39
Denmark 100 100 100 100 100 100 – – 93 90 90 85 – 90 – – – – – – –
Djibouti 92 98 52 56 63 10 26 90 90 88 88 85 88 88 79 62 43 33 30 20 1
Dominica – – – – – – 100 99 99 98 99 99 98 98 – – – – – – –
Dominican Republic 86 87 84 83 87 74 100 98 96 88 86 79 84 81 87 70 57 55 – – –
Ecuador 94 97 88 92 96 84 100 99 99 99 99 98 98 99 74 – – – – – –
Egypt 99 100 98 94 97 92 75 98 97 97 97 96 97 – 86 73 58 19 – – –
El Salvador 87 94 76 87 89 83 – 91 97 92 92 92 92 92 88 67 51 – – – –
Equatorial Guinea – – – – – – 100 73 65 33 39 51 – – 75 – – 36 x – 1x 49 x
Eritrea 61 74 57 14 52 4 14 99 99 99 99 99 99 99 93 44 x – 54 x 71 49 13
Estonia 98 99 97 95 96 94 – 97 96 94 94 95 94 94 – – – – – – –
Ethiopia 38 98 26 12 29 8 5 69 90 86 86 81 86 86 88 19 x 5x 15 x 53 33 10
Fiji – – – – – – – 99 99 99 99 94 99 99 94 – – – – – –
Statistical tables 97
TABLE 3: HEALTH
% under- % under-
fives with fives with Malaria 2006–2010*
Immunization 2010
suspected % under- diarrhoea
% of population % of population % of routine pneumonia fives with receiving %
using improved using improved EPI vaccines 1-year-old children immunized against: taken to an suspected oral rehy- % of % under-fives
drinking water sanitation financed by % appropriate pneumonia dration and house- under- with fever
sources facilities government TB DPT Polio Measles HepB Hib newborns health care receiving continued holds fives receiving
2008 2008 2010 corresponding vaccines: protected provider antibiotics feeding with at sleeping anti-
against least one under malarial
Countries and territories total urban rural total urban rural total BCG DPT1β DPT3β polio3 measles HepB3 Hib3 tetanusλ 2006–2010* 2006–2010* ITN ITNs drugs
Nepal 88 93 87 31 51 27 39 94 85 82 83 86 82 – 81 43 25 37 – – 0
Netherlands 100 100 100 100 100 100 100 – 99 97 97 96 – 97 – – – – – – –
New Zealand 100 100 100 – – – 100 – 95 93 93 91 90 89 – – – – – – –
Nicaragua 85 98 68 52 63 37 41 98 99 98 99 99 98 98 81 58 x – 49 x – – 2x
Niger 48 96 39 9 34 4 14 83 80 70 75 71 70 70 84 47 – 34 76 64 –
Nigeria 58 75 42 32 36 28 71 76 77 69 79 71 66 – 69 45 23 25 42 29 49
Niue 100 100 100 100 100 100 100 99 99 99 99 99 99 99 – – – – – – –
Norway 100 100 100 100 100 100 100 – 99 93 93 93 – 94 – – – – – – –
Occupied Palestinian Territory 91 91 91 89 91 84 – 99 98 96 97 98 95 96 – 65 x – – – – –
Oman 88 92 77 – 97 – – 99 99 99 99 97 98 99 91 – – – – – –
Pakistan 90 95 87 45 72 29 100 95 90 88 88 86 88 88 84 69 50 37 0 – 3
Palau – – – – 96 – 0 – 99 49 48 75 80 66 – – – – – – –
Panama 93 97 83 69 75 51 90 97 98 94 94 95 94 94 – – – – – – –
Papua New Guinea 40 87 33 45 71 41 59 79 80 56 61 55 56 56 61 63 – – – – –
Paraguay 86 99 66 70 90 40 100 92 96 90 88 94 98 98 85 – – – – – –
Peru 82 90 61 68 81 36 100 95 97 93 92 94 93 93 85 68 51 – – – –
Philippines 91 93 87 76 80 69 – 90 89 87 86 88 85 – 75 50 42 60 – – 0x
Poland 100 100 100 90 96 80 100 94 99 99 96 98 98 99 – – – – – – –
Portugal 99 99 100 100 100 100 100 96 99 98 97 96 97 97 – – – – – – –
Qatar 100 100 100 100 100 100 – 99 98 97 98 99 97 97 – – – – – – –
Republic of Korea 98 100 88 100 100 100 48 96 96 94 95 98 94 – – – – – – – –
Republic of Moldova 90 96 85 79 85 74 58 98 93 90 97 97 98 63 – 60 x – 48 x – – –
Romania – – – 72 88 54 100 99 99 97 96 95 98 – – – – – – – –
Russian Federation 96 98 89 87 93 70 – 96 99 97 98 98 97 – – – – – – – –
Rwanda 65 77 62 54 50 55 25 75 92 80 80 82 80 80 85 28 13 – 82 70 11
Saint Kitts and Nevis 99 99 99 96 96 96 100 91 98 95 90 99 96 96 – – – – – – –
Saint Lucia 98 98 98 – – – 100 97 98 97 97 95 97 97 – – – – – – –
Saint Vincent and the Grenadines – – – – – 96 100 90 99 99 99 99 99 99 – – – – – – –
Samoa – – – 100 100 100 100 91 97 87 86 61 87 87 – – – – – – –
San Marino – – – – – – – – 95 92 92 93 92 92 – – – – – – –
Sao Tome and Principe 89 89 88 26 30 19 6 99 98 98 98 92 98 98 – 75 – – 61 56 8
Saudi Arabia – 97 – – 100 – – 98 98 98 98 98 98 98 – – – – – – –
Senegal 69 92 52 51 69 38 100 80 80 70 70 60 70 70 88 47 x – 43 x 60 29 9
Serbia 99 99 98 92 96 88 – 99 97 91 91 95 89 91 – 93 x 57 x 71 x – – –
Seychelles – 100 – – 97 – 100 99 99 99 99 99 99 99 – – – – – – –
Sierra Leone 49 86 26 13 24 6 – 99 96 90 89 82 90 90 85 46 27 57 37 26 30
Singapore 100 100 – 100 100 – – 99 98 97 97 95 96 – – – – – – – –
Slovakia 100 100 100 100 100 99 100 98 99 99 99 98 99 99 – – – – – – –
Slovenia 99 100 99 100 100 100 – – 98 96 96 95 – 96 – – – – – – –
Solomon Islands – – – – 98 – 45 85 85 79 78 68 79 79 85 73 23 – 49 40 19
Somalia 30 67 9 23 52 6 0 29 55 45 49 46 – – 64 13 32 7 12 11 8
South Africa 91 99 78 77 84 65 100 86 73 63 67 65 56 45 77 65 x – – – – –
South Sudanδ – – – – – – – – – – – – – – – – – – 53 25 36
Spain 100 100 100 100 100 100 100 – 99 97 97 95 97 97 – – – – – – –
Sri Lanka 90 98 88 91 88 92 57 99 99 99 99 99 99 99 86 58 – 67 5 3 0
Sudanδ – – – – – – – – – – – – – – – – – – – – –
Suriname 93 97 81 84 90 66 100 – 99 88 88 89 88 86 93 74 37 28 – 3x –
Swaziland 69 92 61 55 61 53 – 98 95 89 89 94 89 89 86 73 24 22 4 1 1
Sweden 100 100 100 100 100 100 – 23 99 98 98 96 – 98 – – – – – – –
Switzerland 100 100 100 100 100 100 0 – 98 96 95 90 – 94 – – – – – – –
Syrian Arab Republic 89 94 84 96 96 95 – 90 89 80 83 82 84 80 94 77 71 34 – – –
Tajikistan 70 94 61 94 95 94 – 82 95 93 95 94 93 93 – 64 x 41 x 22 x – – 2x
Thailand 100 100 99 89 92 82 95 99 99 99 99 98 98 – 91 84 65 46 – – –
The former Yugoslav
Republic of Macedonia 98 99 98 96 95 96 – 98 98 95 95 98 90 89 – 93 x 74 x 45 x – – –
Timor-Leste 69 86 63 50 76 40 100 71 75 72 72 66 72 – 81 71 45 63 41 41 6
Togo 60 87 41 12 24 3 8 94 97 92 92 84 92 92 81 – 41 24 56 57 34
Tonga 100 100 100 96 98 96 90 99 99 99 99 99 99 99 – – – – – – –
Trinidad and Tobago 94 98 93 92 92 92 100 – 96 90 91 92 90 90 – 74 34 – – – –
Tunisia 94 99 84 85 96 64 – 98 98 98 98 97 98 – 96 59 – 62 – – –
Turkey 99 100 96 90 97 75 – 96 97 96 96 97 94 96 90 – – 22 – – –
Turkmenistan – 97 – 98 99 97 – 99 99 96 96 99 96 58 – 83 50 25 – – –
Tuvalu 97 98 97 84 88 81 2 99 99 89 89 85 89 89 – – – – – – –
Uganda 67 91 64 48 38 49 36 84 83 60 55 55 60 60 85 73 47 39 47 33 60
Ukraine 98 98 97 95 97 90 – 95 96 90 91 94 84 81 – – – – – – –
United Arab Emirates 100 100 100 97 98 95 – 98 94 94 94 94 94 94 – – – – – – –
United Kingdom 100 100 100 100 100 100 – – 98 96 98 93 – 97 – – – – – – –
United Republic of Tanzania 54 80 45 24 32 21 18 99 98 91 94 92 91 91 83 71 – 50 64 64 59
United States 99 100 94 100 100 99 – – 99 95 93 92 92 93 – – – – – – –
Uruguay 100 100 100 100 100 99 100 99 98 95 95 95 95 95 – – – – – – –
Uzbekistan 87 98 81 100 100 100 – 99 99 99 99 98 99 99 – 68 56 28 – – –
Vanuatu 83 96 79 52 66 48 – 81 78 68 67 52 59 – 73 – – 43 – – –
Venezuela (Bolivarian Republic of) – – – – – – 100 92 90 78 74 79 78 78 50 72 x – 51 x – – –
Viet Nam 94 99 92 75 94 67 28 94 93 93 94 98 88 63 87 83 55 65 19 – 3
Yemen 62 72 57 52 94 33 20 65 94 87 88 73 87 87 66 – 38 48 – – –
Zambia 60 87 46 49 59 43 19 89 99 82 66 91 82 82 90 68 47 56 64 50 34
Zimbabwe 82 99 72 44 56 37 0 90 94 83 84 84 83 83 76 43 16 35 27 17 24
MEMORANDUM
Sudan and South Sudanδ 57 64 52 34 55 18 55 90 99 90 90 90 75 75 74 90 – 56 18 28 54
SUMMARY INDICATORS#
Africa 65 85 52 41 55 32 46 85 86 79 81 78 77 59 80 53 35 36 44 34 39
Sub-Saharan Africa 60 83 47 31 44 24 41 84 85 77 79 75 74 61 79 51 31 37 44 34 39
Eastern and Southern Africa 59 87 47 36 55 28 31 85 89 80 79 79 78 77 83 58 – 43 51 40 30
West and Central Africa 61 82 46 27 35 21 49 83 80 72 78 71 71 46 77 42 28 32 40 30 45
Middle East and North Africa 86 93 76 80 90 66 – 92 95 91 92 90 89 48 84 76 62 40 – – –
Asia 87 96 82 49 63 40 84 ** 92 90 84 84 85 70 16 86 ** 66 ** 23 ** 41 ** – – 6 **
South Asia 86 95 83 35 57 26 90 88 85 76 75 77 51 22 87 66 18 37 – – 7
East Asia and Pacific 88 96 81 60 66 55 – 97 96 94 96 95 94 7 84 ** 66 ** – 57 ** – – 1 **
Latin America and Caribbean 93 97 80 80 86 55 99 96 96 93 93 93 90 92 84 55 – – – – –
CEE/CIS 94 98 88 89 93 82 – 96 97 95 96 96 94 57 – – – – – – –
Industrialized countries 100 100 98 99 100 98 – – 98 95 95 93 66 85 – – – – – – –
Developing countries 84 94 76 52 68 40 76 ** 90 90 84 84 84 75 38 84 ** 61 ** 30 ** 39 ** – – 19 **
Least developed countries 62 80 54 36 50 31 23 84 88 80 80 78 78 73 83 51 – 46 47 37 34
World 87 96 78 61 76 45 77 ** 90 91 85 86 85 75 42 84 ** 61 ** 30 ** 39 ** – – 19 **
# For a complete list of countries and territories in the regions, subregions and country categories, see page 124.
δ Because of the cession in July 2011 of the Republic of South Sudan by the Republic of the Sudan, and its subsequent admission to the United Nations on 14 July 2011, disaggregated data for the Sudan and South Sudan as separate States are
not yet available for most indicators. Aggregated data presented are for the Sudan pre-cession (see Memorandum item).
Statistical tables 99
TABLE 4: HIV/AIDS
Mother-to-child Paediatric Prevention among Orphans
Estimated number transmission infections young people (aged 15–24) Children Children Orphan
Estimated of people (all ages) Estimated number Estimated number HIV % who have % who used (aged 0–17) (aged 0–17) school
adult (aged living with HIV, of women (aged of children (aged prevalence comprehensive condom at last orphaned by orphaned due to attendance
15–49) HIV 2009 (thousands) 15+) living with 0–14) living with among young knowledge of higher-risk sex, AIDS, 2009 all causes, 2009 ratio
prevalence low high HIV, 2009 HIV, 2009 people (%), 2009 HIV, 2005–2010* 2005–2010* estimate estimate 2005–
Countries and territories (%), 2009 estimate estimate estimate (thousands) (thousands) total male female male female male female (thousands) (thousands) 2010*
Afghanistan – – – – – – – – – – – – – – – –
Albania – – – – – – – – – 22 36 55 25 – – –
Algeria 0.1 18 13 24 5 – <0.1 0.1 <0.1 – 13 – – – 550 –
Andorra – – – – – – – – – – – – – – – –
Angola 2.0 200 160 250 110 22 1.1 0.6 1.6 32 25 – – 140 1,500 85
Antigua and Barbuda – – – – – – – – – – – – – – – –
Argentina 0.5 110 88 140 36 – 0.2 0.3 0.2 – – – – – 630 –
Armenia 0.1 2 2 2 <1.0 – <0.1 <0.1 <0.1 15 23 86 – – 46 –
Australia 0.1 20 15 25 6 – 0.1 0.1 0.1 – – – – – 80 –
Austria 0.3 15 12 20 5 – 0.2 0.3 0.2 – – – – – 28 –
Azerbaijan 0.1 4 3 5 2 – 0.1 <0.1 0.1 5 5 31 – – 190 –
Bahamas 3.1 7 3 11 4 – 2.2 1.4 3.1 – – – – – 7 –
Bahrain – – – – – – – – – – – – – – – –
Bangladesh <0.1 6 5 8 2 – <0.1 <0.1 <0.1 18 8 – – – 4,800 84
Barbados 1.4 2 2 3 <1.0 – 1.0 0.9 1.1 – – – – – 2 –
Belarus 0.3 17 13 20 8 – 0.1 <0.1 0.1 – 34 – – – 150 –
Belgium 0.2 14 11 18 4 – <0.1 <0.1 <0.1 – – – – – 47 –
Belize 2.3 5 4 6 3 – 1.3 0.7 1.8 – 40 – 50 – 6 –
Benin 1.2 60 52 69 32 5 0.5 0.3 0.7 35 16 45 28 30 310 90
Bhutan 0.2 <1.0 <1.0 2 <0.5 – 0.1 0.1 <0.1 – 21 – 62 – 21 –
Bolivia (Plurinational State of) 0.2 12 9 16 4 – 0.1 0.1 0.1 28 24 49 – – 320 –
Bosnia and Herzegovina – – – – – – – – – – 44 – 71 – – –
Botswana 24.8 320 300 350 170 16 8.5 5.2 11.8 – – – – 93 130 –
Brazil – – 460 810 – – – – – – – – – – – –
Brunei Darussalam – – – – – – – – – – – – – – – –
Bulgaria 0.1 4 3 5 1 – <0.1 <0.1 <0.1 15 17 70 57 – 94 –
Burkina Faso 1.2 110 91 140 56 17 0.6 0.5 0.8 – 19 – 64 140 770 61 p
Burundi 3.3 180 160 190 90 28 1.5 1.0 2.1 – 30 – 25 200 610 85
Cambodia 0.5 63 42 90 35 – 0.1 0.1 0.1 45 50 84 – – 630 83
Cameroon 5.3 610 540 670 320 54 2.7 1.6 3.9 – 32 – 62 330 1,200 91
Canada 0.3 68 53 83 21 – 0.1 0.1 0.1 – – – – – 45 –
Cape Verde – – – – – – – – – 36 36 79 56 – – –
Central African Republic 4.7 130 110 140 67 17 1.6 1.0 2.2 26 17 60 41 140 370 96
Chad 3.4 210 170 300 110 23 1.7 1.0 2.5 – 10 – 28 120 670 117
Chile 0.4 40 32 51 12 – 0.2 0.2 0.1 – – – – – 140 –
China 0.1 740 540 1,000 230 – – – – – – – – – – –
Colombia 0.5 160 120 210 50 – 0.2 0.2 0.1 – 24 – 45 – 820 85
Comoros 0.1 <0.5 <0.2 <0.5 <0.1 – <0.1 <0.1 <0.1 – – – – <0.1 22 –
Congo 3.4 77 68 87 40 8 1.9 1.2 2.6 22 8 38 20 51 220 88
Cook Islands – – – – – – – – – – – – – – – –
Costa Rica 0.3 10 8 13 3 – 0.2 0.2 0.1 – – – – – 36 –
Côte d'Ivoire 3.4 450 390 510 220 – 1.1 0.7 1.5 28 18 53 39 – 1,100 83
Croatia <0.1 <1.0 <1.0 1 <0.5 – <0.1 <0.1 <0.1 – – – – – 44 –
Cuba 0.1 7 6 9 2 – 0.1 0.1 0.1 – 54 – 71 – 86 –
Cyprus – – – – – – – – – – – – – – – –
Czech Republic <0.1 2 2 2 <1.0 – <0.1 <0.1 <0.1 – – – – – 92 –
Democratic People's
Republic of Korea – – – – – – – – – – 8 – – – – –
Democratic Republic
of the Congo – – 430 560 – – – – – – 15 – 6 – – 74
Denmark 0.2 5 4 6 1 – 0.1 0.1 0.1 – – – – – 51 –
Djibouti 2.5 14 10 18 7 – 1.3 0.8 1.9 – 18 51 26 – 47 –
Dominica – – – – – – – – – – – – – – – –
Dominican Republic 0.9 57 49 66 32 – 0.5 0.3 0.7 34 41 70 44 – 190 77
Ecuador 0.4 37 28 50 11 – 0.2 0.2 0.2 – – – – – 210 –
Egypt <0.1 11 8 17 2 – <0.1 <0.1 <0.1 18 5 – – – 1,700 –
El Salvador 0.8 34 25 44 11 – 0.3 0.4 0.3 – 27 – – – 150 –
Equatorial Guinea 5.0 20 14 26 11 2 3.5 1.9 5.0 – – – – 4 45 –
Eritrea 0.8 25 18 33 13 3 0.3 0.2 0.4 – – – – 19 240 –
Estonia 1.2 10 8 12 3 – 0.2 0.3 0.2 – – – – – 19 –
Ethiopia – – – – – – – – – 33 20 50 28 – – 90
Fiji 0.1 <1.0 <0.5 <1.0 <0.2 – 0.1 0.1 0.1 – – – – – 23 –
Nauru – – – – – – – – – 10 13 17 10 – – –
Nepal 0.4 64 51 80 20 – 0.2 0.2 0.1 44 28 78 – – 650 –
Netherlands 0.2 22 17 32 7 – 0.1 0.1 <0.1 – – – – – 82 –
New Zealand 0.1 3 2 3 <1.0 – <0.1 <0.1 <0.1 – – – – – 36 –
Nicaragua 0.2 7 5 9 2 – 0.1 0.1 0.1 – – – – – 120 –
Niger 0.8 61 56 66 28 – 0.4 0.2 0.5 16 13 37 18 y 57 970 67
Nigeria 3.6 3,300 2,900 3,600 1,700 360 2.0 1.2 2.9 33 22 49 36 2,500 12,000 117
Niue – – – – – – – – – – – – – – – –
Norway 0.1 4 3 5 1 – <0.1 <0.1 <0.1 – – – – – 35 –
Occupied Palestinian Territory – – – – – – – – – – – – – – – –
Oman 0.1 1 <1.0 1 <0.5 – <0.1 <0.1 <0.1 – – – – – 41 –
Pakistan 0.1 98 79 120 28 – 0.1 0.1 <0.1 – 3 – – – 4,200 –
Palau – – – – – – – – – – – – – – – –
Panama 0.9 20 14 36 6 – 0.3 0.4 0.3 – – – – – 53 –
Papua New Guinea 0.9 34 30 39 18 3 0.6 0.3 0.8 – – 50 35 – 260 –
Paraguay 0.3 13 10 16 4 – 0.2 0.2 0.1 – – – – – 150 –
Peru 0.4 75 58 100 18 – 0.2 0.2 0.1 – 19 – 33 – 550 –
Philippines <0.1 9 6 13 3 – <0.1 <0.1 <0.1 – 21 – 13 – 1,900 –
Poland 0.1 27 20 34 8 – <0.1 <0.1 <0.1 – – – – – 440 –
Portugal 0.6 42 32 53 13 – 0.2 0.3 0.2 – – – – – 58 –
Qatar <0.1 <0.2 <0.1 <0.2 <0.1 – <0.1 <0.1 <0.1 – – – – – 14 –
Republic of Korea <0.1 10 7 13 3 – <0.1 <0.1 <0.1 – – – – – 280 –
Republic of Moldova 0.4 12 10 16 5 – 0.1 0.1 0.1 39 y 42 y 76 60 – 79 –
Romania 0.1 16 12 20 5 – <0.1 0.1 <0.1 – – – – – 290 –
Russian Federation 1.0 980 840 1,200 480 – – 0.2 0.3 – – – – – – –
Rwanda 2.9 170 140 190 88 22 1.6 1.3 1.9 54 51 40 26 130 690 82
Saint Kitts and Nevis – – – – – – – – – – – – – – – –
Saint Lucia – – – – – – – – – – – – – – – –
Saint Vincent and
the Grenadines – – – – – – – – – – – – – – – –
Samoa – – – – – – – – – 6 3 – – – – –
San Marino – – – – – – – – – – – – – – – –
Sao Tome and Principe – – – – – – – – – 43 43 64 54 – – –
Saudi Arabia – – – – – – – – – – – – – – – –
Senegal 0.9 59 50 69 32 – 0.5 0.3 0.7 24 19 52 36 19 520 83
Serbia 0.1 5 4 7 1 – 0.1 0.1 0.1 – 42 – 74 – 94 –
Seychelles – – – – – – – – – – – – – – – –
Sierra Leone 1.6 49 40 63 28 3 1.0 0.6 1.5 28 17 22 10 15 320 62
Singapore 0.1 3 3 4 1 – <0.1 <0.1 <0.1 – – – – – 17 –
Slovakia <0.1 <0.5 <0.5 <0.5 <0.1 – <0.1 <0.1 <0.1 – – – – – 54 –
Slovenia <0.1 <1.0 <0.5 <1.0 <0.2 – <0.1 <0.1 <0.1 – – – – – 12 –
Solomon Islands – – – – – – – – – 35 29 26 17 – – –
Somalia 0.7 34 25 48 15 – 0.5 0.4 0.6 – 4 – – – 630 78
South Africa 17.8 5,600 5,400 5,900 3,300 330 9.0 4.5 13.6 – – – – 1,900 3,400 –
South Sudanδ – – – – – – – – – – – – – – – –
Spain 0.4 130 120 150 32 – 0.1 0.2 0.1 – – – – – <0.1 –
Sri Lanka <0.1 3 2 4 <1.0 – <0.1 <0.1 <0.1 – – – – – 340 –
Sudanδ – – – – – – – – – – – – – – – –
Suriname 1.0 4 3 5 1 – 0.5 0.6 0.4 – 41 – 49 – 12 –
Swaziland 25.9 180 170 200 100 14 11.0 6.5 15.6 54 58 91 73 69 100 99
Sweden 0.1 8 6 11 3 – <0.1 <0.1 <0.1 – – – – – 63 –
Switzerland 0.4 18 13 24 6 – 0.2 0.2 0.1 – – – – – <0.1 –
Syrian Arab Republic – – – – – – – – – – 7 – – – – –
Tajikistan 0.2 9 6 13 3 – <0.1 <0.1 <0.1 13 14 – – – 220 –
Thailand 1.3 530 420 660 210 – – – – – 46 – – – 1,400 93
The former Yugoslav
Republic of Macedonia – – – – – – – – – – 27 – 70 – – –
Timor-Leste – – – – – – – – – 20 12 – – – – 75
Togo 3.2 120 99 150 67 11 1.5 0.9 2.2 – 15 – 50 66 240 94
Tonga – – – – – – – – – – – – – – – –
Trinidad and Tobago 1.5 15 11 19 5 – 0.9 1.0 0.7 – 54 – 51 – 25 –
Tunisia <0.1 2 2 3 <1.0 – <0.1 <0.1 <0.1 – – – – – 130 –
SUMMARY INDICATORS#
Africa 3.9 23,300 21,900 24,600 11,800 3,100 1.9 1.1 2.7 33 24 51 33 15,000 57,600 92
Sub-Saharan Africa 4.8 23,200 21,900 24,500 11,800 3,100 2.2 1.3 3.2 35 26 51 33 15,000 55,100 92
Eastern and Southern Africa 7.1 16,400 15,600 17,300 8,400 2,200 3.2 1.9 4.5 39 34 54 37 10,100 26,600 89
West and Central Africa 2.8 6,500 6,100 7,100 3,300 900 1.4 0.8 2.1 30 20 47 31 4,700 26,400 94
Middle East and North Africa 0.2 400 300 490 160 30 0.1 0.1 0.1 – – – – 200 5,700 –
Asia 0.2 4,800 4,300 5,300 1,600 180 0.1 0.1 0.1 32 ** 19 ** 40 ** 22 ** 1,100 73,200 74 **
South Asia 0.2 2,500 2,200 2,900 900 110 0.1 0.1 0.1 34 17 38 22 580 43,000 73
East Asia and Pacific 0.2 2,300 1,900 2,600 720 69 0.1 0.1 0.1 – 24 ** – – 540 30,600 –
Latin America and Caribbean 0.4 1,600 1,400 1,900 590 57 0.2 0.2 0.2 – – – – 730 9,800 –
CEE/CIS 0.7 1,500 1,300 1,700 500 18 0.4 0.4 0.4 – – – – 86 6,600 –
Industrialized countries 0.4 2,200 1,900 2,700 560 2 0.1 0.2 0.1 – – – – 110 4,400 –
Developing countries 0.9 30,000 28,200 31,500 14,100 3,400 0.5 0.3 0.6 32 ** 20 ** – 27 ** 16,900 145,000 81 **
Least developed countries 2.0 10,100 9,300 10,700 4,900 1,600 1.0 0.6 1.4 30 22 – 30 7,400 41,700 85
World 0.8 34,000 31,600 35,200 15,100 3,400 0.4 0.3 0.6 – 21 ** – – 17,100 153,000 –
# For a complete list of countries and territories in the regions, subregions and country categories, see page 124.
δ Because of the cession in July 2011 of the Republic of South Sudan by the Republic of the Sudan, and its subsequent admission to the United Nations on 14 July 2011, disaggregated data for the Sudan and South Sudan as separate States are
not yet available for most indicators. Aggregated data presented are for the Sudan pre-cession (see Memorandum item).
SUMMARY INDICATORS#
Africa 79 70 53 13 19 18 104 96 80 77 70 67 63 87 36 30 35 33
Sub-Saharan Africa 77 67 45 10 18 17 104 95 78 74 67 65 61 86 30 24 31 28
Eastern and
Southern Africa 79 72 42 8 22 21 114 108 87 87 70 70 51 82 32 28 26 24
West and Central Africa 73 61 48 13 15 13 97 85 70 63 66 61 69 90 29 20 36 32
Middle East
and North Africa 93 87 90 22 23 22 101 94 90 85 83 78 90 92 65 58 54 51
Asia 92 86 67 20 48 48 112 109 – – 86 ** 83 ** – 93 ** 63 48 57 ** 50 **
South Asia 85 72 59 8 47 47 – – – – 83 79 – 93 – – 55 46
East Asia and Pacific 99 99 74 30 50 50 110 112 – – 96 ** 96 ** 79 ** – 66 68 64 ** 66 **
Latin America and Caribbean 97 97 98 34 69 69 119 115 95 95 93 93 88 – 71 76 70 75
CEE/CIS 99 99 124 36 55 54 99 98 94 93 92 92 96 – 82 81 82 78
Industrialized countries 100 100 106 76 81 80 102 102 96 97 – – – – 90 92 – –
Developing countries 91 85 70 21 41 41 110 106 90 88 81 ** 79 ** 73 ** 91 ** 61 49 53 ** 48 **
Least developed countries 75 66 34 4 13 13 106 98 81 78 68 66 61 82 31 25 29 25
World 92 87 78 29 46 46 109 105 91 89 81 ** 79 ** 76 ** 91 ** 65 55 53 ** 49 **
# For a complete list of countries and territories in the regions, subregions and country categories, see page 124.
δ Because of the cession in July 2011 of the Republic of South Sudan by the Republic of the Sudan, and its subsequent admission to the United Nations on 14 July 2011, disaggregated data for the Sudan and South Sudan as separate States are
not yet available for most indicators. Aggregated data presented are for the Sudan pre-cession (see Memorandum item).
DEFINITIONS OF THE INDICATORS Secondary school net attendance ratio – Number of children attending secondary or tertiary school who are of
Youth literacy rate – Number of literate persons aged 15–24 years, expressed as a percentage of the total population official secondary school age, expressed as a percentage of the total number of children of official secondary school
in that group. age. Because of the inclusion of secondary-school-aged children attending tertiary school, this indicator can also be
referred to as a secondary adjusted net attendance ratio.
Pre-primary school gross enrolment ratio – Number of children enrolled in pre-primary school, regardless of age,
expressed as a percentage of the total number of children of official pre-primary school age. All data refer to official International Standard Classifications of Education (ISCED) for the primary and
secondary education levels and thus may not directly correspond to a country-specific school system.
Primary school gross enrolment ratio – Number of children enrolled in primary school, regardless of age,
expressed as a percentage of the total number of children of official primary school age. MAIN DATA SOURCES
Primary school net enrolment ratio – Number of children enrolled in primary or secondary school who are of official Youth literacy – UNESCO Institute for Statistics (UIS).
primary school age, expressed as a percentage of the total number of children of official primary school age. Because Mobile phone and Internet use – International Telecommunications Union, Geneva.
of the inclusion of primary-school-aged children enrolled in secondary school, this indicator can also be referred to as a
Pre-primary, primary and secondary enrolment – UIS. Estimates based on administrative data from national
primary adjusted net enrolment ratio.
Education Management Information Systems (EMIS) with United Nations population estimates.
Primary school net attendance ratio – Number of children attending primary or secondary school who are of official
Primary and secondary school attendance – Demographic and Health Surveys (DHS), Multiple Indicator Cluster
primary school age, expressed as a percentage of the total number of children of official primary school age. Because
Surveys (MICS) and other national household surveys.
of the inclusion of primary-school-aged children attending secondary school, this indicator can also be referred to as a
primary adjusted net attendance ratio. Survival rate to last primary grade – Administrative data: UIS; survey data: DHS and MICS. Regional and global
averages calculated by UNICEF.
Survival rate to last primary grade – Percentage of children entering the first grade of primary school who
eventually reach the last grade of primary school. Notes
Mobile phones – The number of active subscriptions to a public mobile telephone service, including the number of – Data not available.
prepaid SIM cards active during the past three months. x Data refer to years or periods other than those specified in the column heading. Such data are not included in the
Internet users – The estimated number of Internet users out of the total population. This includes those using the calculation of regional and global averages. Estimates from data years prior to 2000 are not displayed.
Internet from any device (including mobile phones) in the last 12 months. y Data differ from the standard definition or refer to only part of a country. Such data are included in the calculation
Secondary school net enrolment ratio – Number of children enrolled in secondary school who are of official of regional and global averages.
secondary school age, expressed as a percentage of the total number of children of official secondary school age. z Data provided by Chinese Ministry of Education. The UIS data do not currently publish net enrolment rates
Secondary net enrolment ratio does not include secondary-school-aged children enrolled in tertiary education owing for China.
to challenges in age reporting and recording at that level. * Data refer to the most recent year available during the period specified in the column heading.
** Excludes China.
SUMMARY INDICATORS#
Africa 477,383 155,135 2.7 2.4 2.1 20 15 11 46 41 35 46 52 57 4.5 40 4.3 3.5 3.3
Sub-Saharan Africa 419,324 138,075 2.8 2.5 2.3 20 16 13 47 44 37 44 50 54 4.9 37 4.6 3.9 3.6
Eastern and Southern Africa 192,994 62,198 2.8 2.5 2.2 19 15 12 47 43 35 47 51 55 4.6 30 4.6 3.6 3.5
West and Central Africa 205,670 69,372 2.7 2.6 2.4 22 18 14 47 45 40 42 48 53 5.4 44 4.6 4.1 3.7
Middle East and North Africa 156,444 47,524 3.0 2.1 1.5 16 8 5 44 34 24 52 63 71 2.8 59 4.3 2.8 2.1
Asia 1,151,806 316,151 2.0 1.3 0.8 13 9 7 38 27 18 56 64 69 2.2 39 3.9 3.0 2.0
South Asia 612,649 175,146 2.3 1.8 1.2 17 11 8 40 33 23 49 59 65 2.7 30 3.8 2.7 2.6
East Asia and Pacific 539,157 141,004 1.8 1.0 0.4 10 7 7 36 23 14 61 68 72 1.8 46 3.9 3.2 1.7
Latin America and Caribbean 195,713 53,461 2.2 1.4 0.9 10 7 6 37 27 19 60 68 74 2.2 79 3.2 2.1 1.2
CEE/CIS 95,544 28,015 1.0 0.2 0.2 10 11 11 20 18 14 66 68 70 1.8 64 1.9 0.3 0.6
Industrialized countries 203,008 57,212 0.7 0.6 0.4 10 9 9 17 13 12 71 76 80 1.7 77 1.0 0.9 0.7
Developing countries 1,953,940 563,545 2.2 1.5 1.1 13 9 8 39 29 21 55 63 68 2.6 45 3.8 2.9 2.1
Least developed countries 389,258 122,520 2.5 2.4 2.1 22 15 10 47 43 34 43 51 59 4.2 29 4.8 4.1 3.8
World 2,201,180 633,933 1.8 1.3 0.9 12 9 8 33 26 20 59 65 70 2.5 50 2.6 2.2 1.7
# For a complete list of countries and territories in the regions, subregions and country categories, see page 124.
δ Because of the cession in July 2011 of the Republic of South Sudan by the Republic of the Sudan, and its subsequent admission to the United Nations on 14 July 2011, disaggregated data for the Sudan and South Sudan as separate States are
not yet available for most indicators. Aggregated data presented are for the Sudan pre-cession (see Memorandum item).
SUMMARY INDICATORS#
Africa 1,483 2,809 0.9 2.1 24 42 – – – 41,779 3 18 5
Sub-Saharan Africa 1,192 2,145 0.0 2.0 31 49 – – – 39,110 4 18 4
Eastern and Southern Africa 1,486 2,750 0.3 1.9 38 45 – – – 20,175 3 12 5
West and Central Africa 905 1,604 -0.5 1.8 22 52 – – – 16,484 4 22 2
Middle East and North Africa 2,752 5,232 -0.2 2.4 9 3 – – – 13,388 2 – –
Asia 2,913 5,578 4.5 6.9 6 27 1 5 11 23,857 0 17 5
South Asia 1,241 3,271 2.1 4.5 7 40 2 3 13 14,187 1 21 5
East Asia and Pacific 4,286 7,472 5.6 7.4 5 16 1 6 10 9,669 0 16 5
Latin America and Caribbean 7,859 11,133 1.4 1.6 30 6 – – – 7,544 0 20 16
CEE/CIS 7,263 13,288 – 2.3 55 4 6 6 9 7,113 0 – –
Industrialized countries 40,845 38,009 2.4 1.6 2 – 19 4 12 – – – –
Developing countries 3,304 5,805 2.5 4.8 16 26 3 8 10 85,729 0 19 9
Least developed countries 669 1,374 -0.2 3.2 52 50 – – – 39,907 8 12 5
World 8,796 10,740 2.4 2.6 8 25 15 5 11 88,559 0 18 9
# For a complete list of countries and territories in the regions, subregions and country categories, see page 124.
δ Because of the cession in July 2011 of the Republic of South Sudan by the Republic of the Sudan, and its subsequent admission to the United Nations on 14 July 2011, disaggregated data for the Sudan and South Sudan as separate States are
not yet available for most indicators. Aggregated data presented are for the Sudan pre-cession (see Memorandum item).
SUMMARY INDICATORS#
Africa 104 76 92 84 99 30 78 49 53 48 5 – 590 36
Sub-Saharan Africa 104 76 92 79 99 23 78 47 50 46 3 – 640 31
Eastern and Southern Africa 104 81 95 88 101 36 89 51 49 48 3 – 550 38
West and Central Africa 104 70 87 70 99 16 71 45 50 47 3 – 720 26
Middle East and North Africa 105 81 93 92 99 45 77 – 75 58 19 – 170 190
Asia 105 86 98 97 100 ** 66 79 52 ** 66 59 14 – 200 210
South Asia 104 68 – 88 100 51 70 46 48 43 9 – 290 110
East Asia and Pacific 105 94 101 105 – 78 92 79 ** 90 79 22 – 88 600
Latin America and Caribbean 109 98 97 108 – 74 96 87 90 87 38 – 85 480
CEE/CIS 113 98 99 96 – 69 95 – 97 93 – – 34 1,700
Industrialized countries 107 100 100 100 – – – – – – 28 – 14 4,300
Developing countries 105 86 96 96 99 ** 61 80 56 ** 66 59 14 – 290 120
Least developed countries 104 75 93 82 100 33 73 40 46 41 5 – 590 37
World 106 90 96 97 99 ** 63 81 56 ** 67 60 15 – 260 140
# For a complete list of countries and territories in the regions, subregions and country categories, see page 124.
δ Because of the cession in July 2011 of the Republic of South Sudan by the Republic of the Sudan, and its subsequent admission to the United Nations on 14 July 2011, disaggregated data for the Sudan and South Sudan as separate States are
not yet available for most indicators. Aggregated data presented are for the Sudan pre-cession (see Memorandum item).
† The maternal mortality data in the column headed ‘reported’ refer to data reported by national authorities. The data in the column headed ‘adjusted’ refer to the 2008 United Nations inter-agency maternal mortality estimates that were
released in late 2010. Periodically, the United Nations Inter-agency Group (WHO, UNICEF, UNFPA and the World Bank) produces internationally comparable sets of maternal mortality data that account for the well-documented problems of
under-reporting and misclassification of maternal deaths, including also estimates for countries with no data. Please note that owing to an evolving methodology, these values are not comparable with previously reported maternal mortality
ratio ‘adjusted’ values. Comparable time series on maternal mortality ratios for the years 1990, 1995, 2000, 2005 and 2008 are available at <www.childinfo.org>.
SUMMARY INDICATORS#
Africa 29 30 29 11 34 44 47 27 28 – 57 – – –
Sub-Saharan Africa 32 33 32 12 38 38 41 27 23 38 58 – – –
Eastern and Southern Africa 33 35 31 11 35 35 42 – – 45 59 – – –
West and Central Africa 34 33 35 14 41 41 33 24 22 29 57 – – –
Middle East and North Africa 10 11 9 4 18 75 – – – – – 90 – –
Asia 12** 12** 12** 14 ** 39 ** 44 ** – – – 44 ** 48 ** – – –
South Asia 13 13 12 18 46 36 – – – 49 52 – – –
East Asia and Pacific 10** 11** 10** 3 ** 18 ** 72 ** – – – – 36 ** – – –
Latin America and Caribbean 8 9 7 8 29 91 – – – – – – – –
CEE/CIS 5 5 4 1 11 96 – – – – 27 – – –
Industrialized countries – – – – – – – – – – – – – –
Developing countries 17** 17** 16** 12 ** 35 ** 51 ** – – – 43 ** 49 ** – – –
Least developed countries 29 30 28 17 47 31 – – – 39 55 – – –
World 17** 17** 16** 12 ** 35 ** 51 ** – – – – 48 ** – – –
# For a complete list of countries and territories in the regions, subregions and country categories, see page 124.
δ Because of the cession in July 2011 of the Republic of South Sudan by the Republic of the Sudan, and its subsequent admission to the United Nations on 14 July 2011, disaggregated data for the Sudan and South Sudan as separate States are
not yet available for most indicators. Aggregated data presented are for the Sudan pre-cession (see Memorandum item).
Averages presented at the end of each Malaysia; Marshall Islands; Micronesia is no established convention for
of the 13 statistical tables are calculated (Federated States of); Mongolia; the designation of ‘developed’ and
using data from the countries and Myanmar; Nauru; Niue; Palau; Papua ‘developing’ countries or areas in the
territories as classified below. New Guinea; Philippines; Republic of United Nations system.
Korea; Samoa; Singapore; Solomon
Africa Islands; Thailand; Timor-Leste; Tonga; Afghanistan; Algeria; Angola; Antigua
Sub-Saharan Africa; North Africa Tuvalu; Vanuatu; Viet Nam and Barbuda; Argentina; Armenia;
(Algeria, Egypt, Libya, Morocco, Tunisia) Azerbaijan; Bahamas; Bahrain;
Latin America and Caribbean Bangladesh; Barbados; Belize; Benin;
Sub-Saharan Africa Antigua and Barbuda; Argentina; Bhutan; Bolivia (Plurinational State of);
Eastern and Southern Africa; West Bahamas; Barbados; Belize; Bolivia Botswana; Brazil; Brunei Darussalam;
and Central Africa; Djibouti; Sudan1 (Plurinational State of); Brazil; Chile; Burkina Faso; Burundi; Cambodia;
Colombia; Costa Rica; Cuba; Dominica; Cameroon; Cape Verde; Central African
Eastern and Southern Africa Dominican Republic; Ecuador; El Republic; Chad; Chile; China; Colombia;
Angola; Botswana; Burundi; Comoros; Salvador; Grenada; Guatemala; Guyana; Comoros; Congo; Cook Islands; Costa
Eritrea; Ethiopia; Kenya; Lesotho; Haiti; Honduras; Jamaica; Mexico; Rica; Côte d’Ivoire; Cuba; Cyprus;
Madagascar; Malawi; Mauritius; Nicaragua; Panama; Paraguay; Peru; Democratic Republic of the Congo;
Mozambique; Namibia; Rwanda; Saint Kitts and Nevis; Saint Lucia; Saint Democratic People’s Republic of Korea;
Seychelles; Somalia; South Africa; Vincent and the Grenadines; Suriname; Djibouti; Dominica; Dominican Republic;
South Sudan1; Swaziland; Uganda; Trinidad and Tobago; Uruguay; Venezuela Ecuador; Egypt; El Salvador; Equatorial
United Republic of Tanzania; (Bolivarian Republic of) Guinea; Eritrea; Ethiopia; Fiji; Gabon;
Zambia; Zimbabwe Gambia; Georgia; Ghana; Grenada;
CEE/CIS Guatemala;Guinea; Guinea-Bissau;
West and Central Africa Albania; Armenia; Azerbaijan; Belarus; Guyana; Haiti; Honduras; India; Indonesia;
Benin; Burkina Faso; Cameroon; Cape Bosnia and Herzegovina; Bulgaria; Iran (Islamic Republic of); Iraq; Israel;
Verde; Central African Republic; Chad; Croatia; Georgia; Kazakhstan; Kyrgyzstan; Jamaica; Jordan; Kazakhstan; Kenya;
Congo; Côte d’Ivoire; Democratic Republic Montenegro; Republic of Moldova; Kiribati; Kuwait; Kyrgyzstan; Lao People’s
of the Congo; Equatorial Guinea; Gabon; Romania; Russian Federation; Serbia; Democratic Republic; Lebanon; Lesotho;
Gambia; Ghana; Guinea; Guinea-Bissau; Tajikistan; The former Yugoslav Republic Liberia; Libya; Madagascar; Malawi;
Liberia; Mali; Mauritania; Niger; Nigeria; of Macedonia; Turkey; Turkmenistan; Malaysia; Maldives; Mali; Marshall
Sao Tome and Principe; Senegal; Ukraine; Uzbekistan Islands; Mauritania; Mauritius; Mexico;
Sierra Leone; Togo Micronesia (Federated States of);
Industrialized countries/territories Mongolia; Morocco; Mozambique;
Middle East and North Africa Industrialized countries/territories are Myanmar; Namibia; Nauru; Nepal;
Algeria; Bahrain; Djibouti; Egypt; Iran defined as those not included in the Nicaragua; Niger; Nigeria; Niue; Occupied
(Islamic Republic of); Iraq; Jordan; Kuwait; UNICEF Regional Classification. Palestinian Territory; Oman; Pakistan;
Lebanon; Libya; Morocco; Occupied Palau; Panama; Papua New Guinea;
Palestinian Territory; Oman; Qatar; Saudi Andorra; Australia; Austria; Belgium; Paraguay; Peru; Philippines; Qatar;
Arabia; Sudan1; Syrian Arab Republic; Canada; Cyprus; Czech Republic; Republic of Korea; Rwanda; Saint Kitts
Tunisia; United Arab Emirates; Yemen Denmark; Estonia; Finland; France; and Nevis; Saint Lucia; Saint Vincent
Germany; Greece; Holy See; Hungary; and the Grenadines; Samoa; Sao Tome
Asia Iceland; Ireland; Israel; Italy; Japan; and Principe; Saudi Arabia; Senegal;
South Asia; East Asia and Pacific Latvia; Liechtenstein; Lithuania; Seychelles; Sierra Leone; Singapore;
Luxembourg; Malta; Monaco; Solomon Islands; Somalia; South Africa;
South Asia Netherlands; New Zealand; Norway; South Sudan1; Sri Lanka; Sudan1;
Afghanistan; Bangladesh; Bhutan; India; Poland; Portugal; San Marino; Slovakia; Suriname; Swaziland; Syrian Arab
Maldives; Nepal; Pakistan; Sri Lanka Slovenia; Spain; Sweden; Switzerland; Republic; Tajikistan; Thailand; Timor-Leste;
United Kingdom; United States Togo; Tonga; Trinidad and Tobago; Tunisia;
East Asia and Pacific Turkey; Turkmenistan; Tuvalu; Uganda;
Brunei Darussalam; Cambodia; China; Developing countries/territories United Arab Emirates; United Republic
Cook Islands; Democratic People’s Developing countries/territories of Tanzania; Uruguay; Uzbekistan;
Republic of Korea; Fiji; Indonesia; Kiribati; are classified as such for purposes Vanuatu; Venezuela (Bolivarian Republic
Lao People’s Democratic Republic; of statistical analysis only. There of); Viet Nam; Yemen; Zambia; Zimbabwe
Least developed countries/territories If development is to be measured using a it is much more difficult for a wealthy
Least developed countries/territories comprehensive and inclusive assessment, minority to affect a nation’s U5MR, and
are those countries and territories it is necessary to appraise human as well this indicator therefore presents a more
classified as such by the United Nations. as economic progress. From UNICEF’s accurate, if far from perfect, picture
point of view, there is a need for an of the health status of the majority of
Afghanistan; Angola; Bangladesh; agreed method of measuring the level of children and of society as a whole.
Benin; Bhutan; Burkina Faso; Burundi; child well-being and its rate of change.
Cambodia; Central African Republic; The speed of progress in reducing
Chad; Comoros; Democratic Republic The under-five mortality rate (U5MR) U5MR can be assessed by calcul-
of the Congo; Djibouti; Equatorial Guinea; is used in Table 10 (pp. 126–129) as the ating its average annual rate of reduction
Eritrea; Ethiopia; Gambia; Guinea; principal indicator of such progress. In (AARR). Unlike the comparison of absolute
Guinea-Bissau; Haiti; Kiribati; Lao 1970, around 16.6 million children were changes, AARR reflects the fact that the
People’s Democratic Republic; Lesotho; dying every year. In 2010, by comparison, lower limits to U5MR are approached only
Liberia; Madagascar; Malawi; Mali; the estimated number of children who with increasing difficulty.
Mauritania; Mozambique; Myanmar; died before their fifth birthday stood at
Nepal; Niger; Rwanda; Samoa; Sao Tome 7.6 million – highlighting a significant As lower levels of under-five mortality
and Principe; Senegal; Sierra Leone; long-term decline in the global number are reached, the same absolute reduc-
Solomon Islands; Somalia; South Sudan1; of under-five deaths. tion represents a greater percentage
Sudan1; Timor-Leste; Togo; Tuvalu; reduction. AARR therefore shows a higher
Uganda; United Republic of Tanzania; U5MR has several advantages as a gauge rate of progress for a 10-point reduction,
Vanuatu; Yemen; Zambia of child well-being: for example, if that reduction happens
at a lower level of under-five mortality. A
• First, U5MR measures an end result of 10-point decrease in U5MR from 100 to
the development process rather than an 90 represents a reduction of 10 per cent,
‘input’ such as school enrolment level, whereas the same 10-point decrease
per capita calorie availability or number from 20 to 10 represents a reduction of
of doctors per thousand population – all 50 per cent. (A negative value for the
of which are means to an end. percentage reduction indicates an increase
in U5MR during the period specified.)
• Second, U5MR is known to be the
result of a wide variety of inputs: for When used in conjunction with gross
example, antibiotics to treat pneumonia; domestic product (GDP) growth rates,
insecticide-treated mosquito nets to U5MR and its rate of reduction can there-
prevent malaria; the nutritional well- fore give a picture of the progress being
being and health knowledge of mothers; made by any country, territory or region,
the level of immunization and oral over any period of time, towards the
rehydration therapy use; the availability satisfaction of some of the most essential
of maternal and child health services, human needs.
including antenatal care; income and
food availability in the family; the avail- As Table 10 shows, there is no fixed
ability of safe drinking water and basic relationship between the annual reduc-
sanitation; and the overall safety of the tion rate of U5MR and the annual rate of
child’s environment. growth in per capita GDP. Such compari-
sons help shed light on the relationship
• Third, U5MR is less susceptible to the between economic advances and
1
Because of the cession in July 2011 of the fallacy of the average than, for example, human development.
Republic of South Sudan by the Republic of per capita gross national income (GNI).
the Sudan, and its subsequent admission
to the United Nations on 14 July 2011, This is because the natural scale does Finally, the table gives the total fertility
disaggregated data for the Sudan and
South Sudan as separate States are not yet not allow the children of the rich to rate for each country and territory and the
available for most indicators. Aggregated be one thousand times more likely to corresponding AARR. It is clear that many
data presented are for the Sudan pre-
cession, and these data are included in the survive, even if the human-made scale of the nations that have achieved signifi-
Middle East and North Africa region as well does permit them to have one thousand cant reductions in their U5MR have also
as in all other categories according to the
regional classification described on page 124. times as much income. In other words, achieved significant reductions in fertility.
Afghanistan 11 314 209 151 149 2.0 3.3 0.1 1.7 29 1 – – 7.7 8.0 6.3 -0.2 1.2
Albania 108 – 41 29 18 – 3.5 4.8 4.1 56 38 -0.7 x 5.4 4.9 3.2 1.5 2.1 3.7
Algeria 69 181 68 49 36 4.9 3.3 3.1 3.2 47 27 1.6 1.5 7.4 4.7 2.3 2.3 3.7
Andorra 172 – 9 5 4 – 5.9 2.2 4.1 56 20 – – – – – – –
Angola 8 – 243 200 161 – 1.9 2.2 2.1 34 20 – 4.2 7.3 7.2 5.4 0.1 1.4
Antigua and Barbuda 145 – 26 15 8 – 5.5 6.3 5.9 69 47 8.3 x 1.7 – – – – –
Argentina 126 70 27 20 14 4.8 3.0 3.6 3.3 48 30 -0.7 2.1 3.1 3.0 2.2 0.1 1.5
Armenia 98 – 55 33 20 – 5.1 5.0 5.1 64 39 – 6.1 3.2 2.5 1.7 1.2 1.9
Australia 165 21 9 6 5 4.2 4.1 1.8 2.9 44 17 1.5 2.3 x 2.7 1.9 1.9 1.9 -0.2
Austria 172 29 9 6 4 5.9 4.1 4.1 4.1 56 33 2.4 1.8 2.3 1.5 1.4 2.4 0.3
Azerbaijan 63 – 93 67 46 – 3.3 3.8 3.5 51 31 – 5.5 4.6 3.0 2.2 2.2 1.6
Bahamas 118 31 22 17 16 1.7 2.6 0.6 1.6 27 6 1.9 1.0 3.5 2.6 1.9 1.5 1.7
Bahrain 139 84 17 12 10 8.0 3.5 1.8 2.7 41 17 -1.3 x 2.8 x 6.5 3.7 2.5 2.8 1.9
Bangladesh 61 234 143 86 48 2.5 5.1 5.8 5.5 66 44 0.4 3.5 6.9 4.5 2.2 2.1 3.5
Barbados 98 47 18 17 20 4.8 0.6 -1.6 -0.5 -11 -18 1.7 0.8 x 3.1 1.7 1.6 2.9 0.6
Belarus 156 – 17 14 6 – 1.9 8.5 5.2 65 57 – 4.5 2.3 1.9 1.4 1.0 1.4
Belgium 172 24 10 6 4 4.4 5.1 4.1 4.6 60 33 2.2 1.6 2.2 1.6 1.8 1.7 -0.7
Belize 113 – 44 27 17 – 4.9 4.6 4.8 61 37 2.9 1.9 6.3 4.5 2.8 1.7 2.4
Benin 20 259 178 143 115 1.9 2.2 2.2 2.2 35 20 0.3 1.2 6.7 6.7 5.3 0.0 1.2
Bhutan 52 285 139 89 56 3.6 4.5 4.6 4.5 60 37 – 5.3 6.7 5.8 2.4 0.7 4.4
Bolivia
(Plurinational State of) 55 225 121 82 54 3.1 3.9 4.2 4.0 55 34 -1.1 1.5 6.6 4.9 3.3 1.5 1.9
Bosnia and Herzegovina 145 – 19 10 8 – 6.4 2.2 4.3 58 20 – 8.9 x 2.9 1.7 1.1 2.6 2.0
Botswana 61 127 59 96 48 3.8 -4.9 6.9 1.0 19 50 8.2 3.5 6.6 4.7 2.8 1.7 2.7
Brazil 103 129 59 36 19 3.9 4.9 6.4 5.7 68 47 2.3 1.5 5.0 2.8 1.8 2.9 2.1
Brunei Darussalam 152 – 12 9 7 – 2.9 2.5 2.7 42 22 -2.2 x -0.4 x 5.8 3.5 2.0 2.4 2.7
Bulgaria 130 39 22 21 13 2.9 0.5 4.8 2.6 41 38 3.4 x 3.3 2.2 1.7 1.5 1.1 0.7
Burkina Faso 3 286 205 191 176 1.7 0.7 0.8 0.8 14 8 1.4 2.4 6.6 6.8 5.9 -0.2 0.8
Burundi 14 226 183 164 142 1.1 1.1 1.4 1.3 22 13 1.1 -1.6 6.8 6.5 4.3 0.2 2.0
Cambodia 58 – 121 103 51 – 1.6 7.0 4.3 58 50 – 6.3 x 5.9 5.7 2.6 0.2 4.0
Cameroon 15 214 137 148 136 2.2 -0.8 0.8 0.0 1 8 3.4 0.6 6.2 5.9 4.5 0.2 1.4
Canada 156 22 8 6 6 5.1 2.9 0.0 1.4 25 0 2.0 1.9 2.2 1.7 1.7 1.5 0.0
Cape Verde 69 151 59 46 36 4.7 2.5 2.5 2.5 39 22 – 4.2 6.9 5.3 2.4 1.3 4.0
Central African Republic 9 227 165 176 159 1.6 -0.6 1.0 0.2 4 10 -1.3 -0.7 6.0 5.8 4.6 0.1 1.1
Chad 5 248 207 190 173 0.9 0.9 0.9 0.9 16 9 -1.0 2.9 6.5 6.7 6.0 -0.1 0.5
Chile 142 82 19 11 9 7.3 5.5 2.0 3.7 53 18 1.5 3.4 4.0 2.6 1.9 2.1 1.7
China 108 110 48 33 18 4.1 3.7 6.1 4.9 63 45 6.6 9.2 5.5 2.3 1.6 4.3 1.9
Colombia 103 106 37 27 19 5.3 3.2 3.5 3.3 49 30 1.9 1.5 5.6 3.1 2.4 2.9 1.3
Comoros 34 222 125 104 86 2.9 1.8 1.9 1.9 31 17 0.1 x -0.4 7.1 5.6 4.9 1.2 0.6
Congo 29 150 116 104 93 1.3 1.1 1.1 1.1 20 11 3.1 0.7 6.3 5.4 4.5 0.8 0.8
Cook Islands 142 58 20 13 9 5.3 4.3 3.7 4.0 55 31 – – – – – – –
Costa Rica 139 72 17 13 10 7.2 2.7 2.6 2.7 41 23 0.7 2.6 5.0 3.2 1.8 2.3 2.7
Côte d'Ivoire 18 235 151 148 123 2.2 0.2 1.9 1.0 19 17 -1.9 -1.0 7.9 6.3 4.4 1.2 1.7
Croatia 156 – 13 8 6 – 4.9 2.9 3.9 54 25 – 2.9 2.0 1.7 1.5 0.9 0.7
Cuba 156 40 13 9 6 5.6 3.7 4.1 3.9 54 33 3.9 2.6 x 4.0 1.8 1.5 4.2 0.9
Cyprus 172 – 11 7 4 – 4.5 5.6 5.1 64 43 5.9 x 2.1 x 2.6 2.4 1.5 0.4 2.5
Czech Republic 172 – 14 7 4 – 6.9 5.6 6.3 71 43 – 2.5 2.0 1.8 1.5 0.6 1.1
Democratic People's
Republic of Korea 73 – 45 58 33 – -2.5 5.6 1.6 27 43 – – 4.0 2.4 2.0 2.6 0.9
Democratic Republic
of the Congo 6 244 181 181 170 1.5 0.0 0.6 0.3 6 6 -2.3 -3.1 6.2 7.1 5.8 -0.7 1.0
Denmark 172 16 9 6 4 2.9 4.1 4.1 4.1 56 33 2.0 1.5 2.1 1.7 1.9 1.2 -0.6
Djibouti 31 – 123 106 91 – 1.5 1.5 1.5 26 14 – -1.4 x 7.4 6.2 3.8 0.9 2.5
Dominica 133 54 17 15 12 5.8 1.3 2.2 1.7 29 20 4.7 x 1.7 – – – – –
Dominican Republic 81 127 62 41 27 3.6 4.1 4.2 4.2 56 34 2.1 3.9 6.2 3.5 2.6 2.9 1.5
Ecuador 98 139 52 33 20 4.9 4.5 5.0 4.8 62 39 1.3 1.7 6.3 3.7 2.5 2.7 2.0
Egypt 91 237 94 47 22 4.6 6.9 7.6 7.3 77 53 4.1 2.7 5.9 4.4 2.7 1.6 2.3
El Salvador 118 161 62 34 16 4.8 6.0 7.5 6.8 74 53 -1.9 2.6 6.2 4.0 2.3 2.3 2.8
Equatorial Guinea 19 – 190 152 121 – 2.2 2.3 2.3 36 20 – 19.2 5.7 5.9 5.2 -0.2 0.6
Eritrea 49 – 141 93 61 – 4.2 4.2 4.2 57 34 – -1.5 x 6.6 6.2 4.5 0.3 1.7
Estonia 165 – 21 13 5 – 4.8 9.6 7.2 76 62 1.5 x 5.0 2.1 1.9 1.7 0.4 0.7
Ethiopia 23 247 184 141 106 1.5 2.7 2.9 2.8 42 25 – 2.9 6.8 7.1 4.2 -0.2 2.6
Fiji 113 54 30 23 17 2.9 2.7 3.0 2.8 43 26 0.7 1.2 4.5 3.4 2.7 1.5 1.2
Finland 186 16 7 4 3 4.1 5.6 2.9 4.2 57 25 2.9 2.6 1.9 1.7 1.9 0.3 -0.3
France 172 18 9 5 4 3.5 5.9 2.2 4.1 56 20 2.2 1.3 2.5 1.8 2.0 1.8 -0.6
Gabon 43 – 93 88 74 – 0.6 1.7 1.1 20 16 0.2 -0.9 4.7 5.2 3.3 -0.5 2.3
Gambia 28 285 165 128 98 2.7 2.5 2.7 2.6 41 23 0.7 0.1 6.1 6.1 4.9 0.0 1.1
Georgia 91 – 47 33 22 – 3.5 4.1 3.8 53 33 – 2.7 2.6 2.2 1.6 0.9 1.7
Germany 172 26 9 5 4 5.3 5.9 2.2 4.1 56 20 2.3 1.3 2.0 1.4 1.4 1.9 -0.2
Ghana 43 185 122 99 74 2.1 2.1 2.9 2.5 39 25 -2.0 2.4 7.0 5.6 4.2 1.1 1.5
Greece 172 38 13 8 4 5.4 4.9 6.9 5.9 69 50 1.3 2.6 2.4 1.4 1.5 2.5 -0.3
Grenada 136 – 21 15 11 – 3.4 3.1 3.2 48 27 4.2 x 2.9 4.6 3.8 2.2 0.9 2.7
Guatemala 76 171 78 49 32 3.9 4.6 4.3 4.5 59 35 0.2 1.3 6.2 5.6 4.0 0.6 1.7
Guinea 17 317 229 175 130 1.6 2.7 3.0 2.8 43 26 – 1.2 6.8 6.7 5.2 0.1 1.3
Guinea-Bissau 10 – 210 177 150 – 1.7 1.7 1.7 29 15 0.1 -1.7 6.1 6.6 5.1 -0.5 1.4
Guyana 79 82 66 47 30 1.1 3.4 4.5 3.9 55 36 -1.6 2.5 5.6 2.6 2.3 3.8 0.7
Haiti 7 224 151 109 165 2.0 3.3 -4.1 -0.4 -9 -51 – -1.1 x 5.8 5.4 3.3 0.3 2.4
Holy See – – – – – – – – – – – – – – – – – –
Honduras 88 154 58 37 24 4.9 4.5 4.3 4.4 59 35 0.8 1.6 7.3 5.1 3.1 1.7 2.5
Hungary 156 43 19 11 6 4.1 5.5 6.1 5.8 68 45 3.0 2.9 2.0 1.8 1.4 0.6 1.3
Iceland 193 16 6 4 2 4.9 4.1 6.9 5.5 67 50 3.2 2.2 3.0 2.2 2.1 1.6 0.1
India 46 188 115 86 63 2.5 2.9 3.1 3.0 45 27 2.1 4.9 5.5 3.9 2.6 1.7 2.0
Indonesia 72 165 85 54 35 3.3 4.5 4.3 4.4 59 35 4.7 2.6 5.5 3.1 2.1 2.8 1.9
Iran (Islamic Republic of) 85 196 65 44 26 5.5 3.9 5.3 4.6 60 41 -2.3 2.7 x 6.5 4.8 1.7 1.5 5.3
Iraq 67 115 46 43 39 4.6 0.7 1.0 0.8 15 9 – -2.2 x 7.4 6.0 4.7 1.0 1.2
Ireland 172 23 9 7 4 4.7 2.5 5.6 4.1 56 43 2.8 4.7 3.8 2.0 2.1 3.2 -0.3
Israel 165 – 12 7 5 – 5.4 3.4 4.4 58 29 1.9 1.8 3.8 3.0 2.9 1.2 0.1
Italy 172 33 10 6 4 6.0 5.1 4.1 4.6 60 33 2.8 0.9 2.5 1.3 1.4 3.2 -0.5
Jamaica 88 62 38 30 24 2.4 2.4 2.2 2.3 37 20 -1.3 0.7 5.5 2.9 2.3 3.1 1.2
Japan 186 18 6 5 3 5.5 1.8 5.1 3.5 50 40 3.4 0.8 2.1 1.6 1.4 1.5 0.7
Jordan 91 102 38 29 22 4.9 2.7 2.8 2.7 42 24 2.5 x 2.5 7.9 5.8 3.1 1.6 3.2
Kazakhstan 73 84 57 44 33 1.9 2.6 2.9 2.7 42 25 – 3.9 3.5 2.8 2.6 1.1 0.5
Kenya 35 151 99 111 85 2.1 -1.1 2.7 0.8 14 23 1.2 0.3 8.1 6.0 4.7 1.5 1.2
Kiribati 60 154 87 65 49 2.9 2.9 2.8 2.9 44 25 -5.3 1.2 – – – – –
Kuwait 136 58 15 13 11 6.8 1.4 1.7 1.6 27 15 -6.8 x 2.0 x 7.2 2.6 2.3 5.1 0.6
Kyrgyzstan 68 – 72 52 38 – 3.3 3.1 3.2 47 27 – 0.5 4.9 3.9 2.7 1.2 1.8
Lao People's
Democratic Republic 55 214 145 88 54 1.9 5.0 4.9 4.9 63 39 – 4.3 6.0 6.2 2.7 -0.1 4.0
Latvia 139 – 21 17 10 – 2.1 5.3 3.7 52 41 3.4 4.5 1.9 1.9 1.5 0.0 1.3
Lebanon 91 60 38 29 22 2.3 2.7 2.8 2.7 42 24 – 2.4 5.1 3.1 1.8 2.4 2.8
Lesotho 35 175 89 127 85 3.4 -3.6 4.0 0.2 4 33 2.5 2.2 5.8 4.9 3.2 0.8 2.2
Liberia 24 274 227 169 103 0.9 3.0 5.0 4.0 55 39 -4.2 1.7 6.7 6.5 5.2 0.1 1.1
Libya 113 139 45 27 17 5.6 5.1 4.6 4.9 62 37 – 2.9 x 7.6 4.8 2.6 2.3 3.2
Liechtenstein 193 – 10 6 2 – 5.1 11.0 8.0 80 67 2.2 3.0 x – – – – –
Lithuania 152 – 17 12 7 – 3.5 5.4 4.4 59 42 – 3.5 2.3 2.0 1.5 0.7 1.5
Luxembourg 186 22 8 5 3 5.1 4.7 5.1 4.9 63 40 2.7 2.9 2.0 1.6 1.6 1.1 -0.3
Madagascar 48 177 159 102 62 0.5 4.4 5.0 4.7 61 39 -2.3 -0.2 7.3 6.3 4.7 0.8 1.5
Malawi 30 329 222 167 92 2.0 2.8 6.0 4.4 59 45 -0.1 1.0 7.3 6.8 6.0 0.4 0.6
Malaysia 156 55 18 11 6 5.6 4.9 6.1 5.5 67 45 4.0 3.2 4.9 3.5 2.6 1.6 1.4
Maldives 124 266 102 47 15 4.8 7.7 11.4 9.6 85 68 – 4.9 x 7.2 6.1 1.8 0.8 6.3
Mali 2 371 255 213 178 1.9 1.8 1.8 1.8 30 16 0.2 2.7 6.9 7.1 6.3 -0.1 0.6
Malta 156 27 11 8 6 4.5 3.2 2.9 3.0 45 25 6.5 2.6 x 2.0 2.1 1.3 -0.2 2.3
Marshall Islands 85 98 51 37 26 3.3 3.2 3.5 3.4 49 30 – -1.1 – – – – –
Mauritania 21 218 124 116 111 2.8 0.7 0.4 0.6 10 4 -1.0 0.9 6.8 5.9 4.5 0.7 1.3
Mauritius 124 85 24 19 15 6.3 2.3 2.4 2.4 38 21 3.2 x 3.5 4.0 2.3 1.6 2.7 1.8
Mexico 113 109 49 29 17 4.0 5.2 5.3 5.3 65 41 1.6 1.5 6.7 3.4 2.3 3.4 1.9
Micronesia
(Federated States of) 64 – 56 49 42 – 1.3 1.5 1.4 25 14 – 0.3 6.9 5.0 3.5 1.7 1.8
Monaco 172 – 9 5 4 – 5.9 2.2 4.1 56 20 1.6 2.2 x – – – – –
Mongolia 76 – 107 61 32 – 5.6 6.5 6.0 70 48 – 3.1 7.6 4.1 2.5 3.1 2.5
Montenegro 145 – 18 13 8 – 3.3 4.9 4.1 56 38 – 3.7 x 2.4 1.9 1.7 1.2 0.6
Morocco 69 182 86 55 36 3.7 4.5 4.2 4.4 58 35 1.9 2.4 7.1 4.0 2.3 2.8 2.9
Mozambique 16 281 219 177 135 1.2 2.1 2.7 2.4 38 24 -1.0 x 4.3 6.6 6.2 4.9 0.3 1.2
Myanmar 45 171 112 87 66 2.1 2.5 2.8 2.6 41 24 1.4 8.2 x 6.1 3.4 2.0 2.8 2.7
Namibia 65 113 73 74 40 2.2 -0.1 6.2 3.0 45 46 -2.1 x 2.1 6.5 5.2 3.2 1.1 2.4
Nauru 65 – 40 40 40 – 0.0 0.0 0.0 0 0 – – – – – – –
Nepal 59 252 141 84 50 2.9 5.2 5.2 5.2 65 40 1.0 1.9 6.1 5.2 2.7 0.8 3.2
Netherlands 172 16 8 6 4 3.5 2.9 4.1 3.5 50 33 1.6 2.0 2.4 1.6 1.8 2.2 -0.6
New Zealand 156 21 11 7 6 3.2 4.5 1.5 3.0 45 14 0.8 1.9 3.1 2.1 2.2 2.0 -0.2
Nicaragua 81 159 68 43 27 4.2 4.6 4.7 4.6 60 37 -3.7 1.9 6.9 4.8 2.6 1.9 3.0
Niger 12 328 311 218 143 0.3 3.6 4.2 3.9 54 34 -2.1 -0.2 7.4 7.8 7.1 -0.3 0.5
Nigeria 12 251 213 186 143 0.8 1.4 2.6 2.0 33 23 -1.4 1.9 6.5 6.4 5.5 0.1 0.7
Niue 91 – 14 29 22 – -7.3 2.8 -2.3 -57 24 – – – – – – –
Norway 186 16 9 5 3 2.9 5.9 5.1 5.5 67 40 3.2 2.1 2.5 1.9 1.9 1.5 -0.2
Occupied Palestinian Territory 91 – 45 31 22 – 3.7 3.4 3.6 51 29 – -2.4 x 7.9 6.5 4.5 0.9 1.9
Oman 142 196 47 22 9 7.1 7.6 8.9 8.3 81 59 3.3 2.0 x 7.3 7.2 2.3 0.1 5.7
Pakistan 33 173 124 101 87 1.7 2.1 1.5 1.8 30 14 3.0 1.7 6.6 6.0 3.4 0.5 2.8
Palau 103 – 33 25 19 – 2.8 2.7 2.8 42 24 – -0.2 x – – – – –
Panama 98 68 33 26 20 3.6 2.4 2.6 2.5 39 23 0.3 3.2 5.3 3.0 2.5 2.8 1.0
Papua New Guinea 49 151 90 74 61 2.6 2.0 1.9 1.9 32 18 -0.7 -0.2 6.2 4.8 4.0 1.2 1.0
Paraguay 87 74 50 35 25 2.0 3.6 3.4 3.5 50 29 3.1 0.1 5.7 4.5 3.0 1.2 2.1
Peru 103 164 78 41 19 3.7 6.4 7.7 7.1 76 54 -0.6 3.0 6.3 3.8 2.5 2.5 2.1
Philippines 80 86 59 40 29 1.9 3.9 3.2 3.6 51 28 0.6 2.0 6.3 4.3 3.1 1.9 1.6
Poland 156 36 17 10 6 3.8 5.3 5.1 5.2 65 40 – 4.4 2.2 2.0 1.4 0.4 2.0
Portugal 172 66 15 7 4 7.4 7.6 5.6 6.6 73 43 2.6 1.6 3.0 1.5 1.3 3.3 0.7
Qatar 145 79 21 13 8 6.6 4.8 4.9 4.8 62 38 – – 6.9 4.2 2.3 2.5 3.1
Republic of Korea 165 52 8 6 5 9.4 2.9 1.8 2.4 38 17 6.2 4.2 4.5 1.6 1.3 5.2 0.9
Republic of Moldova 103 68 37 26 19 3.0 3.5 3.1 3.3 49 27 – -0.6 2.6 2.4 1.5 0.3 2.5
Romania 126 64 37 27 14 2.7 3.2 6.6 4.9 62 48 0.9 x 2.8 2.9 1.9 1.4 2.1 1.6
Russian Federation 133 40 27 23 12 2.0 1.6 6.5 4.1 56 48 – 2.1 2.0 1.9 1.5 0.3 1.1
Rwanda 31 213 163 177 91 1.3 -0.8 6.7 2.9 44 49 1.2 2.3 8.1 7.0 5.4 0.7 1.4
Saint Kitts and Nevis 145 71 28 16 8 4.7 5.6 6.9 6.3 71 50 6.3 x 2.2 – – – – –
Saint Lucia 118 63 23 18 16 5.0 2.5 1.2 1.8 30 11 5.3 x 1.0 6.1 3.4 2.0 2.9 2.7
Saint Vincent and
the Grenadines 97 97 27 22 21 6.4 2.0 0.5 1.3 22 5 3.3 3.6 6.0 3.0 2.1 3.6 1.8
Samoa 98 – 27 23 20 – 1.6 1.4 1.5 26 13 – 3.0 6.1 4.8 3.9 1.2 1.1
San Marino 193 – 12 5 2 – 8.8 9.2 9.0 83 60 – – – – – – –
Sao Tome and Principe 37 97 94 87 80 0.2 0.8 0.8 0.8 15 8 – – 6.5 5.4 3.7 0.9 1.9
Saudi Arabia 108 179 45 26 18 6.9 5.5 3.7 4.6 60 31 -1.4 0.4 x 7.3 5.8 2.8 1.1 3.7
Senegal 42 275 139 119 75 3.4 1.6 4.6 3.1 46 37 -0.7 1.1 7.4 6.6 4.8 0.5 1.6
Serbia 152 – 29 13 7 – 8.0 6.2 7.1 76 46 – 1.5 2.4 2.1 1.6 0.6 1.4
Seychelles 126 67 17 14 14 6.9 1.9 0.0 1.0 18 0 2.9 1.8 – – – – –
Sierra Leone 4 361 276 233 174 1.3 1.7 2.9 2.3 37 25 -0.5 1.1 5.9 5.7 5.0 0.1 0.7
Singapore 186 27 8 4 3 6.1 6.9 2.9 4.9 63 25 5.6 3.9 3.2 1.8 1.3 2.9 1.6
Slovakia 145 – 18 12 8 – 4.1 4.1 4.1 56 33 – 3.7 2.5 2.0 1.3 1.0 2.2
Slovenia 186 – 10 5 3 – 6.9 5.1 6.0 70 40 – 3.3 2.3 1.5 1.4 2.0 0.2
Solomon Islands 81 102 45 35 27 4.1 2.5 2.6 2.6 40 23 – -1.0 6.9 5.9 4.2 0.8 1.6
Somalia 1 – 180 180 180 – 0.0 0.0 0.0 0 0 -0.8 – 7.2 6.6 6.3 0.4 0.2
South Africa 51 – 60 78 57 – -2.6 3.1 0.3 5 27 0.1 1.3 5.6 3.7 2.5 2.1 2.0
South Sudan δ – – – – – – – – – – – – – – – – – –
Spain 165 29 11 7 5 4.8 4.5 3.4 3.9 55 29 1.9 2.1 2.9 1.3 1.5 3.8 -0.4
Sri Lanka 113 75 32 23 17 4.3 3.3 3.0 3.2 47 26 3.0 4.1 4.3 2.5 2.3 2.8 0.4
Sudanδ – – – – – – – – – – – – – – – – – –
Suriname 78 – 52 40 31 – 2.6 2.5 2.6 40 23 -2.2 x 1.5 x 5.7 2.7 2.3 3.6 0.8
Swaziland 39 175 96 114 78 3.0 -1.7 3.8 1.0 19 32 3.0 1.6 6.9 5.7 3.4 0.9 2.7
Sweden 186 13 7 4 3 3.1 5.6 2.9 4.2 57 25 1.8 2.2 2.0 2.0 1.9 0.1 0.2
Switzerland 165 18 8 6 5 4.1 2.9 1.8 2.4 38 17 1.2 0.9 2.1 1.5 1.5 1.6 0.2
Syrian Arab Republic 118 119 38 23 16 5.7 5.0 3.6 4.3 58 30 2.0 1.6 7.6 5.3 2.9 1.8 3.0
Tajikistan 46 – 116 93 63 – 2.2 3.9 3.1 46 32 – -0.1 6.9 5.2 3.3 1.4 2.3
Thailand 130 102 32 18 13 5.8 5.8 3.3 4.5 59 28 4.7 2.9 5.6 2.1 1.6 4.9 1.5
The former Yugoslav
Republic of Macedonia 133 – 39 16 12 – 8.9 2.9 5.9 69 25 – 1.0 3.1 2.1 1.4 1.9 2.0
Timor-Leste 54 – 169 104 55 – 4.9 6.4 5.6 67 47 – -0.5 x 5.9 5.3 6.2 0.5 -0.8
Togo 24 217 147 124 103 1.9 1.7 1.9 1.8 30 17 -0.6 0.0 7.1 6.3 4.1 0.6 2.2
Tonga 118 44 25 20 16 2.8 2.2 2.2 2.2 36 20 – 1.6 5.9 4.6 3.9 1.2 0.9
Trinidad and Tobago 81 53 37 32 27 1.8 1.5 1.7 1.6 27 16 0.5 5.0 3.5 2.4 1.6 1.8 2.0
Tunisia 118 182 49 28 16 6.6 5.6 5.6 5.6 67 43 2.5 3.5 6.6 3.6 2.0 3.0 3.0
Turkey 108 200 80 43 18 4.6 6.2 8.7 7.5 78 58 2.0 2.3 5.5 3.0 2.1 3.0 1.9
Turkmenistan 52 – 98 74 56 – 2.8 2.8 2.8 43 24 – 5.1 6.3 4.3 2.4 1.9 3.0
Tuvalu 73 – 57 44 33 – 2.6 2.9 2.7 42 25 – – – – – – –
Uganda 27 193 175 144 99 0.5 1.9 3.7 2.8 43 31 – 3.6 7.1 7.1 6.1 0.0 0.7
Ukraine 130 32 21 18 13 2.1 1.5 3.3 2.4 38 28 – 0.4 2.1 1.9 1.4 0.6 1.3
United Arab Emirates 152 91 22 12 7 7.1 6.1 5.4 5.7 68 42 -4.9 x 0.5 x 6.6 4.4 1.7 2.0 4.6
United Kingdom 165 21 9 7 5 4.2 2.5 3.4 2.9 44 29 2.0 2.1 2.3 1.8 1.9 1.2 -0.1
United Republic of Tanzania 41 208 155 130 76 1.5 1.8 5.4 3.6 51 42 – 2.4 6.8 6.2 5.5 0.4 0.6
United States 145 23 11 9 8 3.7 2.0 1.2 1.6 27 11 2.1 1.8 2.2 1.9 2.1 0.7 -0.3
Uruguay 136 55 23 17 11 4.4 3.0 4.4 3.7 52 35 0.9 2.0 2.9 2.5 2.1 0.7 1.0
Uzbekistan 57 – 77 63 52 – 2.0 1.9 2.0 32 17 – 2.2 6.5 4.2 2.4 2.2 2.8
Vanuatu 126 102 39 23 14 4.8 5.3 5.0 5.1 64 39 1.1 x 6.8 6.3 4.9 3.9 1.2 1.2
Venezuela
(Bolivarian Republic of) 108 62 33 25 18 3.2 2.8 3.3 3.0 45 28 -1.6 0.3 5.4 3.4 2.5 2.2 1.7
Viet Nam 90 – 51 35 23 – 3.8 4.2 4.0 55 34 – 6.0 7.4 3.6 1.8 3.6 3.4
Yemen 40 280 128 100 77 3.9 2.5 2.6 2.5 40 23 – 1.5 x 7.5 8.7 5.2 -0.7 2.5
Zambia 21 179 183 157 111 -0.1 1.5 3.5 2.5 39 29 -2.3 0.6 7.4 6.5 6.3 0.7 0.2
Zimbabwe 37 120 78 115 80 2.2 -3.9 3.6 -0.1 -3 30 -0.4 -3.2 7.4 5.2 3.3 1.8 2.3
MEMORANDUM
Sudan and South Sudanδ 24 158 125 114 103 1.2 0.9 1.0 1.0 18 10 0.1 3.6 6.6 6.0 4.4 0.5 1.5
SUMMARY INDICATORS#
Africa 229 160 142 111 1.8 1.2 2.5 1.8 31 22 0.9 2.1 6.7 5.9 4.5 0.6 1.3
Sub-Saharan Africa 234 174 154 121 1.5 1.2 2.4 1.8 30 21 0.0 2.0 6.7 6.2 4.9 0.3 1.2
Eastern and Southern Africa 215 156 137 98 1.6 1.3 3.4 2.3 37 28 0.3 1.9 6.8 6.0 4.6 0.6 1.4
West and Central Africa 256 196 175 143 1.3 1.1 2.0 1.6 27 18 -0.5 1.8 6.6 6.5 5.4 0.1 1.0
Middle East and North Africa 187 77 55 41 4.4 3.4 2.9 3.2 47 25 -0.2 2.4 6.7 5.0 2.8 1.5 2.8
Asia 146 86 65 48 2.6 2.8 3.0 2.9 44 26 4.5 6.9 5.6 3.2 2.2 2.8 1.9
South Asia 194 120 89 67 2.4 3.0 2.8 2.9 44 25 2.1 4.5 5.7 4.2 2.7 1.6 2.2
East Asia and Pacific 115 55 38 24 3.7 3.7 4.6 4.1 56 37 5.6 7.4 5.6 2.6 1.8 3.8 1.9
Latin America and Caribbean 118 54 35 23 3.9 4.3 4.2 4.3 57 34 1.4 1.6 5.3 3.2 2.2 2.5 1.8
CEE/CIS 88 50 37 23 2.8 3.0 4.8 3.9 54 38 – 2.3 2.8 2.3 1.8 0.9 1.4
Industrialized countries 24 10 7 6 4.4 3.6 1.5 2.6 40 14 2.4 1.6 2.3 1.7 1.7 1.4 -0.1
Developing countries 156 97 80 63 2.4 1.9 2.4 2.2 35 21 2.5 4.8 5.7 3.6 2.6 2.3 1.7
Least developed countries 240 170 138 110 1.7 2.1 2.3 2.2 35 20 -0.2 3.2 6.7 5.9 4.2 0.6 1.7
World 139 88 73 57 2.3 1.9 2.5 2.2 35 22 2.4 2.6 4.7 3.2 2.5 1.9 1.4
# For a complete list of countries and territories in the regions, subregions and country categories, see page 124.
δ Because of the cession in July 2011 of the Republic of South Sudan by the Republic of the Sudan, and its subsequent admission to the United Nations on 14 July 2011, disaggregated data for the Sudan and South Sudan as separate States are
not yet available for most indicators. Aggregated data presented are for the Sudan pre-cession (see Memorandum item).
SUMMARY INDICATORS#
Africa 228,066 22 2 22 25 108 – 57 72 65 52 31 31 23
Sub-Saharan Africa 196,540 23 2 24 28 123 43 57 72 61 44 27 32 25
Eastern and Southern Africa 92,302 23 3 19 27 116 50 60 68 61 47 29 38 33
West and Central Africa 94,232 23 1 28 29 130 – 55 74 61 40 25 27 18
Middle East and North Africa 82,264 20 – 15 – 38 – – – – 89 54 – 5
Asia 655,548 18 5 ** 25 ** 19 ** 36 56 ** 48 ** 89 ** 74 ** 80 51 30 ** 17 **
South Asia 332,513 20 5 30 22 53 56 51 88 71 71 42 35 16
East Asia and Pacific 323,035 16 – 11 ** 8 ** 19 – 38 ** – 86 ** 89 64 – 22 **
Latin America and Caribbean 108,361 19 – 18 – 81 – – – – 102 74 – –
CEE/CIS 55,069 14 – 7 – 34 – 31 – – 93 84 – –
Industrialized countries 114,933 12 – – – 22 – – – – 103 99 – –
Developing countries 1,061,866 19 – 22 ** 20 ** 56 – 50 ** 83 ** 72 ** 77 51 30 ** 19 **
Least developed countries 190,445 23 – 29 32 123 – 56 67 59 46 24 – 21
World 1,202,710 18 – 22 ** 20 ** 52 – 49 ** – 72 ** 80 56 – 19 **
# For a complete list of countries and territories in the regions, subregions and country categories, see page 124.
δ Because of the cession in July 2011 of the Republic of South Sudan by the Republic of the Sudan, and its subsequent admission to the United Nations on 14 July 2011, disaggregated data for the Sudan and South Sudan as separate States are
not yet available for most indicators. Aggregated data presented are for the Sudan pre-cession (see Memorandum item).
SUMMARY INDICATORS#
Africa 60 36 1.7 79 43 1.8 13 21 1.6 38 34 1.1 83 68 1.2 29 20 1.4 55 32 1.7
Sub-Saharan Africa 53 30 1.8 76 40 1.9 15 22 1.5 41 35 1.2 81 66 1.2 33 22 1.5 44 24 1.8
Eastern and Southern Africa 45 27 1.7 78 41 1.9 12 17 1.5 49 41 1.2 85 76 1.1 47 29 1.6 55 28 2.0
West and Central Africa 57 34 1.7 75 40 1.9 15 25 1.7 38 31 1.2 79 57 1.4 28 14 1.9 35 21 1.7
Middle East and North Africa 86 66 1.3 89 65 1.4 8 13 1.6 37 36 1.0 92 81 1.1 – – – 90 66 1.4
Asia 60 ** 38 ** 1.6 ** 83 58 1.4 31 ** 43 ** 1.4 ** 44 ** 38 ** 1.2 ** – – – 31 ** 16 ** 1.9 ** 63 40 1.6
South Asia 50 31 1.6 71 40 1.8 33 45 1.4 40 35 1.2 – – – 33 14 2.3 57 26 2.2
East Asia and Pacific 82 ** 66 ** 1.3 ** 95 87 1.1 – – – 56 ** 55 ** 1.0 ** 98 ** 96 ** 1.0 ** 26 ** 22 ** 1.2 ** 66 55 1.2
Latin America and Caribbean – – – 96 74 1.3 3 8 2.7 – – – – – – – – – 86 55 1.6
CEE/CIS 97 96 1.0 98 92 1.1 – – – – – – 91 91 1.0 – – – 93 82 1.1
Industrialized countries – – – – – – – – – – – – – – – – – – 100 98 1.0
Developing countries 64 ** 40 ** 1.6 ** 84 55 1.5 17 ** 32 ** 1.9 ** 42 ** 37 ** 1.1 ** – – – 29 ** 17 ** 1.7 ** 68 40 1.7
Least developed countries 44 26 1.7 74 39 1.9 19 27 1.4 49 45 1.1 84 73 1.2 33 21 1.6 50 31 1.6
World 65 ** 40 ** 1.6 ** 85 55 1.5 17 ** 32 ** 1.9 ** 42 ** 37 ** 1.1 ** – – – – – – 76 45 1.7
# For a complete list of countries and territories in the regions, subregions and country categories, see page 124.
δ Because of the cession in July 2011 of the Republic of South Sudan by the Republic of the Sudan, and its subsequent admission to the United Nations on 14 July 2011, disaggregated data for the Sudan and South Sudan as separate States are
not yet available for most indicators. Aggregated data presented are for the Sudan pre-cession (see Memorandum item).
Afghanistan – – – – – – – – – – – – – – – – – – – – –
Albania 98 99 1.0 98 100 1.0 8 4 2.2 – – – 89 91 1.0 20 60 3.0 10 38 3.8
Algeria – – – 88 98 1.1 5 2 2.4 19 23 1.2 93 98 1.1 5 20 3.7 – – –
Andorra – – – – – – – – – – – – – – – – – – – – –
Angola 17 48 2.8 23 x 67 x 3.0 x – – – – – – 63 78 1.2 – – – – – –
Antigua and Barbuda – – – – – – – – – – – – – – – – – – – – –
Argentina – – – – – – – – – – – – – – – – – – – – –
Armenia 93 99 1.1 93 x 100 x 1.1 x – – – 53 x 78 x 1.5 x – – – 12 29 2.5 16 20 1.2
Australia – – – – – – – – – – – – – – – – – – – – –
Austria – – – – – – – – – – – – – – – – – – – – –
Azerbaijan 92 97 1.1 76 100 1.3 15 2 7.0 27 28 1.0 72 78 1.1 1 12 10.3 2 14 6.3
Bahamas – – – – – – – – – – – – – – – – – – – – –
Bahrain – – – – – – – – – – – – – – – – – – – – –
Bangladesh 6 19 3.0 9 57 6.2 51 26 1.9 57 70 1.2 – – – – – – – – –
Barbados – – – – – – – – – – – – – – – – – – – – –
Belarus – – – 100 x 100 x 1.0 x 2x 0x 6.7 x – – – 96 94 1.0 31 35 1.1 – – –
Belgium – – – – – – – – – – – – – – – – – – – – –
Belize 93 98 1.1 – – – – – – – – – – – – 28 55 2.0 – – –
Benin 46 75 1.6 52 96 1.9 25 10 2.4 40 47 1.2 39 63 1.6 9 26 3.1 17 52 3.0
Bhutan 100 100 1.0 34 95 2.8 16 7 2.2 61 60 1.0 85 94 1.1 7 32 4.4 – – –
Bolivia
(Plurinational State of) – – – 38 99 2.6 8 2 3.8 28 27 0.9 95 97 1.0 5 40 8.4 11 45 4.3
Bosnia and Herzegovina 99 100 1.0 99 100 1.0 2x 3x 0.5 x 58 47 0.8 99 98 1.0 46 49 1.1 – – –
Botswana – – – 84 x 100 x 1.2 x 16 4 4.0 – – – – – – – – – – – –
Brazil – – – – – – – – – – – – – – – – – – – – –
Brunei Darussalam – – – – – – – – – – – – – – – – – – – – –
Bulgaria – – – – – – – – – – – – – – – – – – – – –
Burkina Faso 52 90 1.7 56 65 1.2 38 18 2.1 38 53 1.4 33 39 1.2 8 37 4.4 – – –
Burundi 58 64 1.1 25 x 55 x 2.2 x – – – 22 x 27 x 1.2 x 59 69 1.2 26 35 1.3 – – –
Cambodia 59 77 1.3 21 x 90 x 4.3 x – – – 56 x 37 x 0.7 x – – – 26 68 2.6 26 64 2.5
Cameroon 51 91 1.8 23 98 4.4 30 5 6.2 16 45 2.8 50 87 1.7 12 50 4.0 – – –
Canada – – – – – – – – – – – – – – – – – – – – –
Cape Verde – – – – – – – – – – – – – – – – – – – – –
Central African Republic 23 83 3.7 27 89 3.3 25 17 1.5 39 55 1.4 31 48 1.5 14 23 1.6 19 33 1.7
Chad 0 37 121.7 8 61 7.6 33 21 1.6 14 41 2.9 – – – 6 18 2.9 – – –
Chile – – – – – – – – – – – – – – – – – – – – –
China – – – – – – – – – – – – – – – – – – – – –
Colombia – – – 93 100 1.1 6 2 3.1 46 64 1.4 90 93 1.0 15 32 2.2 – – –
Comoros 72 93 1.3 49 x 77 x 1.6 x – – – 31 x 34 x 1.1 x 25 x 39 x 1.6 x – – – – – –
Congo 69 y 91 y 1.3 y 40 x 95 x 2.4 x 16 x 5x 3.1 x 36 x 45 x 1.3 x – – – 5 12 2.4 12 27 2.3
Cook Islands – – – – – – – – – – – – – – – – – – – – –
Costa Rica – – – – – – – – – – – – – – – – – – – – –
Côte d'Ivoire 28 89 3.2 29 95 3.3 21 6 3.4 44 60 1.4 35 55 1.6 10 24 2.5 15 42 2.8
Croatia – – – – – – – – – – – – – – – – – – – – –
Cuba – – – – – – – – – – – – – – – – – – – – –
Cyprus – – – – – – – – – – – – – – – – – – – – –
Czech Republic – – – – – – – – – – – – – – – – – – – – –
Democratic People's
Republic of Korea – – – – – – – – – – – – – – – – – – – – –
Democratic Republic
of the Congo 25 27 1.1 59 96 1.6 29 12 2.3 39 38 1.0 65 73 1.1 8 24 2.8 – – –
Denmark – – – – – – – – – – – – – – – – – – – – –
Djibouti – – – – – – – – – – – – – – – – – – – – –
Dominica – – – – – – – – – – – – – – – – – – – – –
Dominican Republic 59 97 1.6 95 99 1.0 – – – 54 57 1.0 82 91 1.1 31 46 1.5 21 41 2.0
Ecuador – – – 99 x 98 x 1.0 x – – – – – – – – – – – – – – –
Egypt 99 100 1.0 55 97 1.8 8 5 1.4 21 14 0.7 81 93 1.1 2 9 4.9 9 28 3.1
El Salvador 98 99 1.0 91 98 1.1 12 y 1y 12.9 y – – – – – – – – – – – –
Equatorial Guinea – – – 47 x 85 x 1.8 x – – – 33 x 28 x 0.9 x – – – – – – – – –
Eritrea – – – 7 x 81 x 12.1 x – – – – – – – – – – – – – – –
Estonia – – – – – – – – – – – – – – – – – – – – –
Ethiopia 3 18 7.0 1 x 27 x 38.0 x 36 x 25 x 1.5 x 10 x 30 x 3.1 x – – – 8 39 4.7 20 50 2.5
Fiji – – – – – – – – – – – – – – – – – – – – –
Finland – – – – – – – – – – – – – – – – – – – – –
France – – – – – – – – – – – – – – – – – – – – –
Gabon 88 92 1.0 – – – – – – 37 x 45 x 1.2 x – – – – – – – – –
Gambia 52 64 1.2 28 89 3.1 24 9 2.6 34 33 1.0 28 42 1.5 32 45 1.4 – – –
Georgia 89 98 1.1 95 x 99 x 1.0 x – – – – – – 90 96 1.1 7 19 2.8 – – –
Germany – – – – – – – – – – – – – – – – – – – – –
Ghana 60 88 1.5 22 94 4.2 19 9 2.2 34 57 1.7 60 88 1.5 17 34 2.1 23 50 2.1
Greece – – – – – – – – – – – – – – – – – – – – –
Grenada – – – – – – – – – – – – – – – – – – – – –
Guatemala – – – – – – 21 y 3y 6.5 y – – – – – – 5 41 7.8 – – –
Guinea 21 83 4.0 26 57 2.2 24 19 1.3 32 x 45 x 1.4 x – – – 10 27 2.8 8 28 3.3
Guinea-Bissau 17 35 2.0 19 79 4.0 22 11 2.1 62 62 1.0 52 65 1.2 6 25 4.3 – – –
Guyana 87 98 1.1 64 93 1.5 16 4 3.8 – – – 89 92 1.0 37 72 2.0 25 65 2.6
Haiti 72 92 1.3 6 68 10.5 22 6 3.6 – – – – – – 18 41 2.2 28 52 1.9
Holy See – – – – – – – – – – – – – – – – – – – – –
Honduras 92 96 1.0 33 99 2.9 16 2 8.1 45 52 1.1 80 90 1.1 13 44 3.4 – – –
Hungary – – – – – – – – – – – – – – – – – – – – –
Iceland – – – – – – – – – – – – – – – – – – – – –
India 24 72 3.1 19 89 4.6 57 20 2.9 29 45 1.5 – – – 4 45 11.7 15 55 3.8
Indonesia 23 84 3.7 65 86 1.3 – – – 55 48 0.9 – – – 3y 23 y 7.5 y 2y 27 y 12.2 y
Iran (Islamic Republic of) – – – – – – – – – – – – – – – – – – – – –
Iraq – – – – – – – – – – – – – – – – – – – – –
Ireland – – – – – – – – – – – – – – – – – – – – –
Israel – – – – – – – – – – – – – – – – – – – – –
Italy – – – – – – – – – – – – – – – – – – – – –
Jamaica – – – – – – – – – – – – – – – – – – – – –
Japan – – – – – – – – – – – – – – – – – – – – –
Jordan – – – 98 100 1.0 3 0 26.0 32 35 1.1 – – – – – – – – –
Kazakhstan 99 100 1.0 100 100 1.0 5 2 2.8 – – – 99 98 1.0 18 28 1.6 – – –
Kenya 48 80 1.7 20 81 4.0 25 9 2.8 49 41 0.8 58 78 1.3 29 61 2.1 42 68 1.6
Kiribati – – – – – – – – – – – – – – – – – – – – –
Kuwait – – – – – – – – – – – – – – – – – – – – –
Kyrgyzstan 94 95 1.0 93 100 1.1 2 2 0.8 49 20 0.4 94 91 1.0 17 29 1.7 – – –
Lao People's
Democratic Republic 62 85 1.4 3 81 27.1 38 14 2.7 – – – 59 84 1.4 – – – – – –
Latvia – – – – – – – – – – – – – – – – – – – – –
Lebanon – – – – – – – – – – – – – – – – – – – – –
Lesotho 42 49 1.2 35 90 2.6 18 9 1.9 49 52 1.1 83 94 1.1 26 48 1.8 14 45 3.3
Liberia 1y 7y 6.1 y 26 81 3.2 21 13 1.6 40 56 1.4 15 56 3.7 14 29 2.1 17 37 2.2
Libya – – – – – – – – – – – – – – – – – – – – –
Liechtenstein – – – – – – – – – – – – – – – – – – – – –
Lithuania – – – – – – – – – – – – – – – – – – – – –
Luxembourg – – – – – – – – – – – – – – – – – – – – –
Madagascar 61 93 1.5 22 90 4.1 40 x 24 x 1.7 x 46 65 1.4 59 96 1.6 10 42 4.3 8 49 6.5
Malawi – – – 43 77 1.8 – – – 24 34 1.4 71 90 1.3 33 52 1.6 34 45 1.3
Malaysia – – – – – – – – – – – – – – – – – – – – –
Maldives 92 94 1.0 89 99 1.1 24 11 2.3 – – – 82 82 1.0 23 y 48 y 2.0 y – – –
Mali 65 96 1.5 35 86 2.5 31 17 1.8 32 51 1.6 37 56 1.5 9 19 2.0 – – –
Malta – – – – – – – – – – – – – – – – – – – – –
Marshall Islands 92 98 1.1 68 99 1.5 – – – – – – – – – 12 39 3.3 37 58 1.6
Mauritania 28 83 2.9 21 95 4.6 – – – 25 37 1.5 41 59 1.5 0 12 29.5 4 27 6.2
Mauritius – – – – – – – – – – – – – – – – – – – – –
Mexico – – – – – – – – – – – – – – – – – – – – –
Micronesia
(Federated States of) – – – – – – – – – – – – – – – – – – – – –
Monaco – – – – – – – – – – – – – – – – – – – – –
Mongolia 99 98 1.0 98 x 100 x 1.0 x 7x 3x 2.8 x 47 x – – 91 96 1.1 18 44 2.4 – – –
Montenegro 94 99 1.0 98 100 1.0 4x 1x 4.1 x – – – 92 100 1.1 23 36 1.6 – – –
Morocco – – – 30 x 95 x 3.2 x 15 x 3x 4.5 x 37 x 50 x 1.3 x 77 95 1.2 – – – – – –
Mozambique 20 48 2.4 37 89 2.4 24 8 3.1 41 55 1.3 72 80 1.1 41 43 1.1 16 45 2.7
Tonga – – – – – – – – – – – – – – – – – – – – –
Trinidad and Tobago 94 98 1.0 98 100 1.0 – – – – – – 95 99 1.0 48 62 1.3 – – –
Tunisia – – – – – – – – – – – – – – – – – – – – –
Turkey 89 99 1.1 73 100 1.4 4 1 8.4 20 33 1.7 87 y 95 y 1.1 y – – – – – –
Turkmenistan 94 97 1.0 99 100 1.0 8x 2x 3.2 x 27 36 1.3 – – – 3 8 2.8 – – –
Tuvalu 39 71 1.8 99 98 1.0 1 0 – – – – – – – 34 y 39 1.2 y – 67 y –
Uganda 17 26 1.5 28 76 2.7 21 8 2.5 39 44 1.1 72 82 1.1 20 47 2.3 28 47 1.6
Ukraine 100 100 1.0 97 99 1.0 – – – – – – 78 75 1.0 33 45 1.4 28 42 1.5
United Arab Emirates – – – – – – – – – – – – – – – – – – – – –
United Kingdom – – – – – – – – – – – – – – – – – – – – –
United Republic
of Tanzania 4 56 12.7 31 90 2.9 22 9 2.3 45 59 1.3 68 93 1.4 39 55 1.4 34 56 1.7
United States – – – – – – – – – – – – – – – – – – – – –
Uruguay – – – – – – – – – – – – – – – – – – – – –
Uzbekistan 100 100 1.0 100 100 1.0 5 3 1.5 – – – 94 96 1.0 25 33 1.3 – – –
Vanuatu 13 41 3.1 55 90 1.6 – – – 38 53 1.4 74 76 1.0 9 23 2.7 – – –
Venezuela
(Bolivarian Republic of) 87 95 1.1 95 x 92 x 1.0 x – – – – – – 86 x 99 x 1.2 x – – – – – –
Viet Nam 72 97 1.3 53 99 1.9 – – – – – – 94 96 1.0 29 61 2.1 – – –
Yemen 5 50 9.3 17 74 4.3 – – – 41 54 1.3 44 73 1.6 0y 4y – – – –
Zambia 5 31 5.8 27 91 3.4 16 11 1.5 53 65 1.2 73 96 1.3 – – – – – –
Zimbabwe 23 68 2.9 39 92 2.4 – – – 27 48 1.8 85 y 97 y 1.1 y – – – – – –
MEMORANDUM
Sudan and South Sudanδ 6 86 14.0 15 90 5.8 31 17 1.9 53 59 1.1 19 y 56 y 2.9 y – – – – – –
SUMMARY INDICATORS#
Africa 28 61 2.2 30 87 2.9 26 10 2.5 32 44 1.4 54 77 1.4 14 34 2.5 20 44 2.2
Sub-Saharan Africa 23 58 2.5 27 85 3.2 28 11 2.6 33 47 1.4 50 74 1.5 15 37 2.4 22 47 2.1
Eastern and
Southern Africa 21 47 2.2 29 84 2.8 – – – 41 49 1.2 65 84 1.3 23 47 2.0 28 53 1.9
West and Central Africa 25 64 2.5 26 86 3.3 31 11 2.7 27 44 1.6 42 69 1.7 10 30 3.2 16 40 2.4
Middle East and
North Africa – – – 47 92 1.9 – – – 33 35 1.1 61 81 1.3 – – – – – –
Asia 27 ** 68 ** 2.5 ** 26 ** 86 ** 3.3 ** 53 ** 20 ** 2.7 ** 36 ** 48 ** 1.3 ** – – – 7 ** 42 ** 5.6 ** 13 ** 51 ** 3.9 **
South Asia 22 63 2.8 19 84 4.5 55 20 2.7 32 47 1.5 – – – 4 45 11.1 15 55 3.7
East Asia and Pacific 46 ** 89 ** 1.9 ** 54 ** 92 ** 1.7 ** – – 54 ** 53 ** 1.0 ** – – – 16 ** 34 ** 2.2 ** – – –
Latin America
and Caribbean – – – – – – – – – – – – – – – – – – – – –
CEE/CIS 94 98 1.0 88 99 1.1 – – – – – – 88 93 1.1 – – – – – –
Industrialized countries – – – – – – – – – – – – – – – – – – – – –
Developing countries 31 ** 67 ** 2.2 ** 31 ** 87 ** 2.8 ** 39 ** 14 ** 2.7 ** 35 ** 47 ** 1.3 ** – – – 10 ** 38 ** 3.9 ** 15 ** 49 ** 3.2 **
Least developed countries 22 49 2.3 29 79 2.7 32 15 2.1 42 53 1.3 57 75 1.3 15 36 2.4 – – –
World 32 ** 67 ** 2.1 ** 32 ** 87 ** 2.7 ** 39 ** 14 ** 2.7 ** 35 ** 47 ** 1.3 ** – – – 10 ** 38 ** 3.8 ** – – –
# For a complete list of countries and territories in the regions, subregions and country categories, see page 124.
δ Because of the cession in July 2011 of the Republic of South Sudan by the Republic of the Sudan, and its subsequent admission to the United Nations on 14 July 2011, disaggregated data for the Sudan and South Sudan as separate States are
not yet available for most indicators. Aggregated data presented are for the Sudan pre-cession (see Memorandum item).
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